Clinical observation on pars plana vitrectomy with sutureless transconjunctival 20 Gauge trocar

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LIU Tao(Department of ophthalmology,3203 Hospital,Hanzhong 723000,China)
XIE An-ming()
TIAN Xiao-yan(Department of ophthalmology,3203 Hospital,Hanzhong 723000,China)
Journal Title:
Volume 25, Issue 01, 2009
Key Word:
Vitrectomy;Retinal detachment/surgery

Abstract: Objective To observe the clinical effect of conventional vitrectomy using transconjunctival sutureless 20 Gauge (20G) trocar.Methods The clinical data of 62 patients (63 eyes) who had undergone vitrectomy were retrospectively analyzed.The patients were divided into 2 groups according to the surgery methods.Group A: conventional vitrectomy using transconjunctival sutureless 20G trocar were performed on 33 cases (34 eyes) including 19 males (20 eyes) and 14 females (14 eyes).The patients aged from 17 to 75 years with the average age ot 52.3 years.The average visual acuity was 0.04 and the average intraocular pressure was 18.25 mm Hg (1 mm Hg=0.133 kPa).Included were 13 cases of diabetic retinopathy,9 cases of vitreous hemorrhage,2 cases of silicone oil removal and tearing membrane off,9 cases of complex retinal detachment,and 1 case of tearing epiretinal macular membrane.Group B: 20G conventional incision vitrectomy was performed on 29 cases (29 eyes) including 13 males (13 eyes) and 16 females (16 eyes) aged from 24 to 69 years with the average age of 49.5 years.The average visual acuity was 0.02 and the average intraocular pressure was 17.50 mm Hg.Included were 10 cases of diabetic retinopathy,8 cases of vitreous hemorrhage,5 cases of retinal detachment,2 cases of long-standing retinal detachment performed with vitrectomy and scleral buckling,and 4 cases of silicone oil removal and tearing membrane off and intravitreal injection of expanding gases.Within group A,21 eyes were treated with intraocular laser photocoagulation,9 eyes were treated with scleral cryosurgery to block the hole,3 eyes were treated with intravitreal injection of expanding gases,and 15 eyes were injected with silicone oil.Leakage of incision,incidence of iatrogenic holes and comfort of patients after operation were recorded and analyzed.All data were analyzed by χ2 test statistical analysis.Results In group A,31 eyes had a good degree of comfort without incision leakage and did not need special treatment;3 eyes filled with inert gas needed suppression for 3 to 5 minutes,and had gas spill from the temporal incision,which needed to be sutured once.In group B,all incisions were sutured with 8-0 silk suture without any incision leakage,whileforeign body sensation and irritation was apparent.Difference on the degree of comfort in the two groups was statistically significant (χ2 = 50.56,P<0.01).No eyes in group A generated iatrogenic hole,while 2 eyes in group B generated ora serrata slit pores next to the puncture.Compared with each other, there was a significant statistical difference (χ2= 4.15,P<0.05).Conclusion Conventional vitrectomy using transconjunctival suturcless 20G trocar made the vitrectomy simpler and quicker and can reduce the incidence of iatrogenic hole significantly.

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