title: Sclerotomy site leakage according to wound shape in 23-gauge microincisional vitrectomy surgery.
abstract: OBJECTIVE
  To compare the shape and self-sealing nature of scleral incision sites according to bevel shape and trocar blade direction in 23-gauge microincisional vitrectomy surgery.
  
  
  METHODS
  Twenty-three-gauge microincisional vitrectomies were performed in 60 eyes using a single-step entry system (Alcon Surgical, USA) and a 23-gauge two-step Eckardt vitrectomy system (DORC, the Netherlands). Trocar cannula were inserted using trocar blades bevel-up (20 eyes) or bevel-down (20 eyes). In 20 eyes, trocars were inserted after sclerotomies were performed using a microvitreoretinal (MVR) blade. After removing the cannula, we compared the scleral wound shapes and looked for leakage.
  
  
  RESULTS
  A total of 180 sclerotomies were done: 60 in the bevel-up direction (group 1), 60 in the bevel-down direction (group 2), and 60 using an MVR blade (group 3). Bevel-up insertion produced a V-shaped sclerotomy wound, whereas bevel-down insertion produced a reverse V-shaped wound. The MVR blade produced a slit-shaped wound. Wound leakage was identified in 21 V-shaped wounds, seven reverse V-shaped wounds, and four slit-shaped wounds. We observed no cases of hypotony, vitreous incarceration, or endophthalmitis.
  
  
  CONCLUSIONS
  The self-sealing effect of slit-shaped wounds and reverse V-shaped wounds was superior to that of V-shaped wounds.
authors.affiliation: Department of Ophthalmology, College of Medicine, Soonchunhyang University, Seoul, Korea. ckseek@hosp.sch.ac.kr
authors.forename: Kyung Seek
authors.initials: KS
authors.lastname: Choi
authors.forename: Hoon Dong
authors.initials: HD
authors.lastname: Kim
authors.forename: Sung Jin
authors.initials: SJ
authors.lastname: Lee
mesh_terms: D000328:Adult; D000368:Aged; D004867:Equipment Design; D005260:Female; D006801:Humans; D008297:Male; D008866:Microsurgery / Q000009:adverse effects* / Q000295:instrumentation / Q000379:methods*; D008875:Middle Aged; D012590:Sclera / Q000473:pathology* / Q000601:surgery*; D013529:Surgical Wound Dehiscence / Q000209:etiology*; D014821:Vitrectomy / Q000009:adverse effects* / Q000295:instrumentation / Q000379:methods*