Risk factors associated with sclerotomy leakage and postoperative hypotony after 23-gauge transconjunctival sutureless vitrectomy.
OBJECTIVE
To investigate the incidence and risk factors of sclertomy leakage and postoperative hypotony after 23-gauge transconjunctival sutureless vitrectomy.


METHODS
This was a retrospective study including 322 eyes of 292 patients who underwent 23-gauge transconjunctival sutureless vitrectomy by a single surgeon with minimum follow-up period of 1 month. The incidence and risk factors of intraoperative suture placement for leaking sclerotomies and postoperative hypotony (</=5 mmHg) were analyzed in association with seven clinical factors.


RESULTS
Intraoperative suture placement was required for leaking sclerotomies in 36 cases (11.2%) and was related to prior vitrectomy (OR = 7.5), young age (<50 years) at operation (OR = 4.9), and vitreous base dissection (OR = 3.5). The incidences of postoperative hypotony were 11.3% at 2 hours, 6.5% at 5 hours, 3.8% at 1 day, and 0% at 1 week. Myopia and gas tamponade were associated with early postoperative hypotony. No complications developed related to sclerotomy leakage or postoperative hypotony.


CONCLUSIONS
The risk factors of intraoperative sclerotomy leakage requiring suture placement after 23-gauge transconjunctival sutureless vitrectomy are prior vitrectomy, a young age at operation, and vitreous base dissection. Caution should be exercised to ensure the detection of sclerotomy leakage and hypotony in cases with these risk factors.
Woo
Se Joon
SJ
Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Korea.
Park
Kyu Hyung
KH
Hwang
Jeong-Min
JM
Kim
Jeong Hun
JH
Yu
Young Suk
YS
Chung
Hum
H
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D003228:Conjunctiva / Q000601:surgery; D004867:Equipment Design; D005260:Female; D005500:Follow-Up Studies; D005740:Gases / Q000008:administration & dosage; D006801:Humans; D015994:Incidence; D007430:Intraoperative Care; D007431:Intraoperative Complications / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009216:Myopia / Q000150:complications; D015814:Ocular Hypotension / Q000453:epidemiology / Q000209:etiology*; D011183:Postoperative Complications; D012086:Reoperation; D012189:Retrospective Studies; D012307:Risk Factors; D012599:Sclerostomy / Q000009:adverse effects*; D013529:Surgical Wound Dehiscence / Q000453:epidemiology / Q000209:etiology* / Q000601:surgery; D013536:Suture Techniques; D013997:Time Factors; D014821:Vitrectomy / Q000009:adverse effects* / Q000295:instrumentation* / Q000379:methods; D014822:Vitreous Body / Q000601:surgery; D055815:Young Adult
D005740:Gases