Effect of intravitreal gas tamponade for sutureless vitrectomy wounds: three-dimensional corneal and anterior segment optical coherence tomography study.
OBJECTIVE
To investigate the effect of gas tamponade on wound closure and postoperative hypotony by comparing fluid-filled and gas-filled eyes after 25-gauge sutureless vitrectomy using three-dimensional corneal and anterior segment optical coherence tomography.


METHODS
Twenty-four eyes of 24 patients who underwent a 25-gauge transconjunctival sutureless vitrectomy were included in this prospective study. A total of 72 scleral wounds were observed using three-dimensional corneal and anterior segment optical coherence tomography at 3 hours and at 1, 3, 7, and 14 days postoperatively. Scleral wound closure was defined as the absence of a scleral gap at the sclerotomy site, as observed using three-dimensional corneal and anterior segment optical coherence tomography. The rate of wound closure, intraocular pressure, and the incidence of complications were compared between the fluid- and gas-filled eyes.


RESULTS
The rates of scleral wound closure at 3 hours and at 1, 3, 7, and 14 days were 26.2%, 28.6%, 35.7%, 52.4%, and 85.7% in fluid-filled eyes and 53.3%, 73.3%, 76.7%, 83.3%, and 93.3% in gas-filled eyes; these rates were significantly higher for the gas-filled eyes. The intraocular pressure was significantly higher in the gas-filled eyes than in the fluid-filled eyes on postoperative Day 1 but did not differ significantly between the 2 groups on postoperative Day 3 and thereafter.


CONCLUSIONS
Three-dimensional corneal and anterior segment optical coherence tomography provided clear images of 25-gauge sutureless vitrectomy wounds and revealed that the sclerotomies closed faster in gas-filled eyes than in fluid-filled eyes. Thus, gas tamponade might be effective for the closure of sutureless vitrectomy wounds.
Department of Ophthalmology, Yokohama City University Medical Center, Yokohama, Japan. shinyama@yokohama-cu.ac.jp
Shin
S
Yamane
Kazuaki
K
Kadonosono
Maiko
M
Inoue
Satoshi
S
Kobayashi
Yoichiro
Y
Watanabe
Akira
A
Arakawa
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D058450:Endotamponade / Q000379:methods*; D019773:Epiretinal Membrane / Q000601:surgery; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods; D007429:Intraocular Pressure / Q000502:physiology; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D016684:Prone Position; D011446:Prospective Studies; D012167:Retinal Perforations / Q000601:surgery; D012590:Sclera / Q000503:physiopathology* / Q000601:surgery; D012599:Sclerostomy; D013459:Sulfur Hexafluoride / Q000008:administration & dosage*; D013536:Suture Techniques; D013997:Time Factors; D041623:Tomography, Optical Coherence; D014065:Tonometry, Ocular; D014821:Vitrectomy / Q000379:methods*; D014822:Vitreous Body; D058106:Wound Closure Techniques; D014945:Wound Healing / Q000502:physiology*
D013459:Sulfur Hexafluoride