Purpose: To evaluate the rate of sclerotomy suturing in a large series of primary 23-gauge vitrectomies.
Methods: Retrospective chart review of 23-gauge transconjunctival pars plana vitrectomies performed between 2008 and 2012 in a multisurgeon retina practice. Patients with a history of retinal surgery, combination of vitrectomy and scleral buckling surgery, or intraoperative conversion of a sclerotomy to 20-gauge were excluded from the study. Vitrectomies were divided into two types according to their degree of complexity and intraoperative use of instrumentation. Demographic and clinical data were gathered from the chart. Location and number of sutured sclerotomies were obtained from the operative report.
Results: A total of 589 eyes from 569 patients were included in this study. At least 1 sclerotomy was sutured in 227 eyes (38.5%): 69 (30.4%) had 1 sutured sclerotomy, 52 (22.9%) had 2 sutured sclerotomies, and 106 (46.7%) had 3 sutured sclerotomies. Sclerotomy suturing was significantly related to the surgical technique (P < 0.001), type of tamponade agent (P = 0.048), and complexity of the vitrectomy (P < 0.001). The incidence of postoperative hypotony at Day 1 was 2.2% and all cases returned to normal intraocular pressure at 1 week. There were no recognized complications related to sclerotomies regardless of suturing.
Conclusion: The factors that increased the rate of sclerotomy suturing were the absence of tamponade agent and higher complexity of the procedure. There was a high variability in the rate of suturing between the surgeons.
The rate of sclerotomy suturing in a large series of primary vitrectomies was 38.5%. There was a high variation in suturing rate amongst the five surgeons included in the study. Absence of tamponade agent and higher complexity of surgery were associated with a higher likelihood of requiring a suture.
*llinois Retina Associates, Chicago, Illinois; and
†Department of Ophthalmology, Rush University Medical Center, Chicago, Illinois.
Reprint requests: Kourous A. Rezaei, MD, 71 West 156th Street, Suite 400, Harvey, IL 60426-4265; e-mail: firstname.lastname@example.org
Presented at the ASRS Annual Meeting, Las Vegas, NV, August 27, 2012.
Supported by Alcon Laboratories, Inc. (advisory board, consultant, other, grants, honoraria); Alimera Sciences (advisory board, honoraria); Bayer Healthcare (grants, honoraria, other); Covalent Medical, Inc. (stockholder, stock, other financial benefit); Genentech (other, grants, honoraria); BMC Ophthalmology (consultant, honoraria); Regeneron Pharmaceuticals, Inc. (other, grants, honoraria); Thrombogenetics, Inc. (advisory board, honoraria).
K. A. Rezaei: Alcon Laboratories (advisory board, consultant, other, grant, honoraria), Alimera Sciences (advisory board, honoraria), Bayer (grants, honoraria, other), Genentech (grant, honorarium), ThromboGenics (advisory board, honorarium), Regeneron (grant, honorarium).
The other authors have no conflicting interests to disclose.
All authors have made substantial contributions to the conception, design, acquisition of data, and analysis and interpretation of data. All authors were involved in drafting or revising the article and gave final approval of the version to be published. All authors had full access to all the data in the study and take responsibility for the integrity of the data and accuracy of the data analysis and the decision to submit this manuscript for publication.