Intraocular gas dynamics after 20-gauge and 23-gauge vitrectomy with sulfur hexafluoride gas tamponade.
OBJECTIVE
The purpose of this study was to evaluate the intraocular gas dynamics after 23-gauge transconjunctival sutureless vitrectomy (TSV) as compared with 20-gauge pars plana vitrectomy (PPV).


METHODS
A consecutive series of 290 eyes that experienced 20-gauge or 23-gauge vitrectomy with 25% sulfur hexafluoride (SF6) gas tamponade were retrospectively reviewed. Intraocular gas bubble size on postoperative Day 1 and Gas50, the interval to dissipate to a 50% gas fill, were evaluated.


RESULTS
The mean intraocular bubble size on postoperative Day 1 was 92.0 ± 8.3% in the 20-gauge PPV cases and 83.8 ± 13.7% in the 23-gauge TSV cases (P < 0.001). The mean Gas50 was 8.6 ± 1.6 days in the 20-gauge PPV cases and 6.6 ± 2.2 days in the 23-gauge TSV cases (P < 0.001). Thorough peripheral vitrectomy and 23-gauge TSV were significantly associated with Gas50 ≤ 4 days (odds ratio, 4.62 and 16.8; P = 0.036 and P = 0.007, respectively). Among thoroughly vitrectomized eyes, 13 eyes treated with 23-gauge PPV with intraoperative suture placement at the sclerotomy sites had gas longevity comparative to those with 20-gauge PPV.


CONCLUSIONS
Eyes treated with 23-gauge TSV tend to have earlier gas disappearance or incomplete gas fill. Intraoperative suture placement would be a solution.
Department of Ophthalmology, Hyogo Prefectural Amagasaki Hospital, Hyogo, Japan.
Sentaro
S
Kusuhara
Sotaro
S
Ooto
Daisaku
D
Kimura
Kyoko
K
Itoi
Hirokazu
H
Mukuno
Noriko
N
Miyamoto
Masayuki
M
Akimoto
Hitoshi
H
Takagi
D005128:Eye Diseases / Q000601:surgery; D005260:Female; D006801:Humans; D007429:Intraocular Pressure / Q000502:physiology; D008297:Male; D008866:Microsurgery / Q000379:methods*; D008875:Middle Aged; D015814:Ocular Hypotension / Q000378:metabolism; D012164:Retinal Diseases / Q000601:surgery*; D012189:Retrospective Studies; D012307:Risk Factors; D012599:Sclerostomy; D013459:Sulfur Hexafluoride / Q000008:administration & dosage / Q000493:pharmacokinetics*; D013529:Surgical Wound Dehiscence / Q000378:metabolism; D013536:Suture Techniques; D014821:Vitrectomy / Q000379:methods*; D014822:Vitreous Body / Q000378:metabolism* / Q000601:surgery*
D013459:Sulfur Hexafluoride