Office-based sutureless transconjunctival pars plana vitrectomy.
OBJECTIVE
This is a preliminary report to describe our technique of office-based vitrectomy (OVIT) and to report the incidence of complications over a 6-year period.


METHODS
In a retrospective, noncomparative case series, OVIT was performed on 225 patients in four participating offices. Each patient was operated on with a 23-gauge vitreous cutter that the authors have developed. They have also developed a 23-gauge transconjunctival infusion needle device. Diagnoses included endophthalmitis, uveitis, intravitreal lens fragments, ghost cell glaucoma, and rhegmatogenous retinal detachment.


RESULTS
The surgical goal was accomplished in all cases, but supplemental office procedures were required for two eyes, and a scleral buckle was necessary in one eye. There were 15 complications in 14 eyes: "fish-egg" gas bubbles (one eye), intraocular hemorrhage (nine eyes), choroidal detachment (two eyes), new retinal breaks (one eye), retinal detachment (one eye), and temporary elevation of intraocular pressure (one eye). The hemorrhages, choroidal detachments, and fish-egg bubbles all resolved spontaneously.


CONCLUSIONS
Office-based sutureless transconjunctival pars plana vitrectomy, with infusion when needed, is an effective operation for selected diseases of the posterior segment. In a multicenter series of 225 eyes, there were 15 complications in 14 (6%) eyes. Two of the complications were successfully managed with additional office procedures; one was managed in the operating room; and 12 resolved spontaneously.
Hilton
George F
GF
University of California Medical School, San Francisco, CA, USA.
Josephberg
Robert G
RG
Halperin
Lawrence S
LS
Madreperla
Steven A
SA
Brinton
Daniel A
DA
Lee
Scott S
SS
Gordon
Stephen F
SF
D000368:Aged; D000369:Aged, 80 and over; D000556:Ambulatory Surgical Procedures; D003228:Conjunctiva; D009877:Endophthalmitis / Q000601:surgery; D005260:Female; D005901:Glaucoma / Q000601:surgery; D006801:Humans; D007431:Intraoperative Complications; D007906:Lens Subluxation / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009339:Needles; D011183:Postoperative Complications; D017410:Practice Guidelines as Topic; D012163:Retinal Detachment / Q000601:surgery; D012189:Retrospective Studies; D013536:Suture Techniques; D014605:Uveitis / Q000601:surgery; D014821:Vitrectomy / Q000295:instrumentation / Q000379:methods*