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INTRAOCULAR GAS DYNAMICS AFTER 20-GAUGE AND 23-GAUGE VITRECTOMY WITH SULFUR HEXAFLUORIDE GAS TAMPONADE

Kusuhara, Sentaro MD, PhD*†; Ooto, Sotaro MD, PhD*; Kimura, Daisaku MD*; Itoi, Kyoko MD*; Mukuno, Hirokazu MD, PhD*; Miyamoto, Noriko MD, PhD*; Akimoto, Masayuki MD, PhD*; Takagi, Hitoshi MD, PhD*‡

doi: 10.1097/IAE.0b013e3181e5870f
Original Study
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Purpose: The purpose of this study was to evaluate the intraocular gas dynamics after 23-gauge transconjunctival sutureless vitrectomy (TSV) as compared with 20-gauge pars plana vitrectomy (PPV).

Methods: A consecutive series of 290 eyes that experienced 20-gauge or 23-gauge vitrectomy with 25% sulfur hexafluoride (SF6) gas tamponade were retrospectively reviewed. Intraocular gas bubble size on postoperative Day 1 and Gas50, the interval to dissipate to a 50% gas fill, were evaluated.

Results: The mean intraocular bubble size on postoperative Day 1 was 92.0 ± 8.3% in the 20-gauge PPV cases and 83.8 ± 13.7% in the 23-gauge TSV cases (P < 0.001). The mean Gas50 was 8.6 ± 1.6 days in the 20-gauge PPV cases and 6.6 ± 2.2 days in the 23-gauge TSV cases (P < 0.001). Thorough peripheral vitrectomy and 23-gauge TSV were significantly associated with Gas50 ≤4 days (odds ratio, 4.62 and 16.8; P = 0.036 and P = 0.007, respectively). Among thoroughly vitrectomized eyes, 13 eyes treated with 23-gauge PPV with intraoperative suture placement at the sclerotomy sites had gas longevity comparative to those with 20-gauge PPV.

Conclusion: Eyes treated with 23-gauge TSV tend to have earlier gas disappearance or incomplete gas fill. Intraoperative suture placement would be a solution.

Eyes treated with 23-gauge TSV tend to have earlier gas disappearance or incomplete gas fill. Intraoperative suture placement would be a solution.

From the *Department of Ophthalmology, Hyogo Prefectural Amagasaki Hospital, Hyogo, Japan; †Division of Ophthalmology, Department of Surgery Related, Kobe University Graduate School of Medicine, Hyogo, Japan; and ‡Department of Ophthalmology, St Marianna University School of Medicine, Kanagawa, Japan.

The authors have no proprietary or commercial interest in any materials discussed in the article and no grant or fund supported this study.

Reprint requests: Hitoshi Takagi, MD, PhD, Department of Ophthalmology, St Marianna University School of Medicine, 2-16-1 Sugao, Miyamae-ku, Kawasaki, Kanagawa, 216-8511 Japan; e-mail: htakagi@marianna-u.ac.jp

© The Ophthalmic Communications Society, Inc.