[23-gauge transconjunctival sutureless vitrectomy: a retrospective study of 164 consecutive cases].
OBJECTIVE
To describe our initial experience and to evaluate the outcomes of patients treated with 23-gauge transconjunctival sutureless vitrectomy for a variety of vitreoretinal conditions.


METHODS
A single-center, retrospective chart review of 164 consecutive 23-gauge vitrectomy cases done by five vitreoretinal surgeons at the CHNO des XV-XX from May 2006 through December 2007. The main outcome measures included visual acuity and intraoperative and postoperative complications.


RESULTS
The mean follow-up duration was 145 days. Mean overall acuity improved from 20/410 (0.5/10) at baseline to 20/101 (2/10) (p<0.0001) and the improvement in visual acuity was statistically significant for patients with macular hole, epiretinal membranes, retinal detachment, nonclearing vitreous hemorrhage, and silicone oil removal. There was a single case of intraoperative retinal tear. There were no postoperative complications of endophthalmitis or choroidal effusion and three cases of hypotony, which resolved spontaneously. Thirty-six of 80 phakic eyes had worsening of cataract, 29 of which occurred in the 1st postoperative month. Twenty patients had cataract surgery during the follow-up. Postoperative retinal detachment occurred in two cases after surgery for nonclearing vitreous hemorrhage. Retinal re-detachment after surgery for retinal detachment occurred in nine of 66 cases (14%).


CONCLUSIONS
Twenty-three-gauge transconjunctival sutureless vitrectomy is an effective surgical technique for a variety of vitreoretinal surgical indications. The safety and efficacy profile compared favorably with the published literature on 20-gauge surgery.
de Preobrajensky
N
N
CHNO des Quinze-vingt, 28, rue de Charenton, Paris, France. ndepreo@gmail.com
Mrejen
S
S
Adam
R
R
Ayello-Scheer
S
S
Gendron
G
G
Rodallec
T
T
Sahel
J-A
JA
Barale
P-O
PO
D000368:Aged; D001035:Aphakia / Q000150:complications; D003228:Conjunctiva / Q000601:surgery*; D019773:Epiretinal Membrane / Q000601:surgery; D004867:Equipment Design; D005260:Female; D005602:France; D006801:Humans; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D012163:Retinal Detachment / Q000209:etiology / Q000601:surgery; D012167:Retinal Perforations / Q000601:surgery; D012189:Retrospective Studies; D013537:Sutures; D016896:Treatment Outcome; D014792:Visual Acuity; D014821:Vitrectomy / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods*; D014823:Vitreous Hemorrhage / Q000601:surgery