title: Comparison of postoperative intraocular pressure changes between 23-gauge transconjunctival sutureless vitrectomy and conventional 20-gauge vitrectomy.
abstract: OBJECTIVE
  To compare the intraocular pressure (IOP) after 23-gauge transconjunctival sutureless vitrectomy (TSV) and conventional 20-gauge vitrectomy for various vitreoretinal diseases.
  
  
  METHODS
  This was a retrospective interventional case series including 338 cases of 23-gauge TSV and 476 cases of 20-gauge vitrectomy with minimum follow-up period of 1 month. Postoperative 1 day, 1 week and 1 month IOPs were compared. Multiple regression analysis to assess the actual effect of gauge of vitrectomy on postoperative IOP was performed including intraoperative and postoperative factors influencing postoperative IOP as covariates.
  
  
  RESULTS
  The mean IOP of 20-gauge vitrectomy was significantly higher than that of 23-gauge TSV (20.6 ± 8.02 mm Hg vs 12.8 ± 4.48 mm Hg, P<0.001) at postoperative day 1, but the differences were not significant at postoperative 1 week and 1 month. The IOP pattern of 23-gauge TSV demonstrated more stable course than that of 20-gauge vitrectomy. At 1 day post vitrectomy, the incidence of hypertony was higher in 20-gauge, whereas that of hypotony was higher in 23-gauge. Among risk factors, the 20-gauge vitrectomy showed the strongest association with postoperative 1 day IOP rise.
  
  
  CONCLUSIONS
  Twenty-three-gauge TSV has stable and lower IOP in the early postoperative period than the 20-gauge vitrectomy. In patients whose retina and optic nerves are vulnerable to higher or fluctuating IOP, 23-gauge TSV may be more beneficial.
authors.affiliation: Department of Ophthalmology, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Korea.
authors.forename: S J
authors.initials: SJ
authors.lastname: Ahn
authors.forename: S J
authors.initials: SJ
authors.lastname: Woo
authors.forename: J
authors.initials: J
authors.lastname: Ahn
authors.forename: K H
authors.initials: KH
authors.lastname: Park
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007429:Intraocular Pressure; D008297:Male; D008866:Microsurgery / Q000379:methods*; D008875:Middle Aged; D009798:Ocular Hypertension / Q000209:etiology*; D011183:Postoperative Complications; D012189:Retrospective Studies; D014821:Vitrectomy / Q000379:methods*; D055815:Young Adult