[Self-sealing sclerotomies in pars plana vitrectomy].
OBJECTIVE
To study a technique of self-sealing sclerotomies, recently described.


METHODS
After conjunctival peritomy, a tunnel incision is performed with a crescent knife, 2 mm posterior to the intended site of entry. Then a 20G microvitreoretinal blade is used to enter the vitreous cavity. From November 1996 to April 1997, 99 primary vitrectomies were prospectively studied.


RESULTS
292 sclerotomies were performed with this technique. Self-sealing sclerotomies were observed in 270 cases (92.5%). In 22 cases, leakage of fluid required closure with 8-0 nylon sutures. Leakage was related to multiple instruments used through the sclerotomy, or more frequently to a thin scleral wall. In 1 case, transient hypotony was observed. Ocular pressure spontaneously returned to normal.


CONCLUSIONS
Self-sealing sclerotomies are difficult to perform if the sclera is thin, and leakage can be observed if multiple instruments have to be used through the same sclerotomy. But this technique prevents vitreous and retinal herniation through the sclerotomy, and ocular hypotony. It also reduces the operative time, and prevents irritation related to nonabsorbable sutures.
Korobelnik
J F
JF
Service d'ophtalmologie, Hôpital Bichat, Paris.
Hannouche
D
D
Cochereau
I
I
Hoang-Xuan
T
T
D006801:Humans; D011183:Postoperative Complications; D011446:Prospective Studies; D012590:Sclera / Q000601:surgery*; D014821:Vitrectomy / Q000379:methods*
Sclérotomies autoétanches lors de la vitrectomie par la pars plana.