title: Two-step oblique incision during 25-gauge vitrectomy reduces incidence of postoperative hypotony.
abstract: The efficacy of a two-step, oblique incision procedure during 25-gauge vitrectomy on postoperative hypotony was evaluated by a retrospective, case-control study. The transconjunctival incision during 25-gauge vitrectomy was made in two steps: penetration with a microvitreoretinal blade followed by a penetrater instrument of a blunt trocar. The two-step procedure was performed on 89 eyes and with the conventional incision on 68 eyes. The incidence of hypotony (intraocular pressure <6 mmHg) on the first postoperative day and after 1 week and 1 month was compared. Hypotony was found in two eyes (2%) with the two-step method and 12 eyes (18%) with the conventional incision on the first postoperative day (P = 0.001, Fisher's exact probability test). The preoperative intraocular pressure was not significantly different in the two groups but was significantly higher in the two-step group than in the conventional method group on the first postoperative day (P = 0.001, Wilcoxon rank test). Twenty-five-gauge vitrectomy with two-step oblique incisions will reduce the incidence of postoperative hypotony on the first postoperative day.
authors.affiliation: Department of Ophthalmology, Keio University School of Medicine, and Kyorin Eye Center, Kyorin University School of Medicine, Tokyo, Japan. inoshin@sc.itc.keio.ac.jp
authors.forename: Makoto
authors.initials: M
authors.lastname: Inoue
authors.forename: Kei
authors.initials: K
authors.lastname: Shinoda
authors.forename: Hajime
authors.initials: H
authors.lastname: Shinoda
authors.forename: Ryosuke
authors.initials: R
authors.lastname: Kawamura
authors.forename: Kotaro
authors.initials: K
authors.lastname: Suzuki
authors.forename: Susumu
authors.initials: S
authors.lastname: Ishida
mesh_terms: D016022:Case-Control Studies; D005260:Female; D006801:Humans; D015994:Incidence; D007429:Intraocular Pressure; D008297:Male; D008875:Middle Aged; D015814:Ocular Hypotension / Q000209:etiology / Q000517:prevention & control*; D011183:Postoperative Complications / Q000517:prevention & control*; D012189:Retrospective Studies; D014065:Tonometry, Ocular; D014821:Vitrectomy / Q000379:methods*