title: Diathermy of leaking sclerotomies after 23-gauge transconjunctival pars plana vitrectomy: a prospective study.
abstract: OBJECTIVE
  To evaluate the efficacy of bipolar diathermy in ensuring closure of leaking sclerotomies after complete 23-gauge transconjunctival sutureless vitrectomy.
  
  
  METHODS
  In this prospective, interventional case series, in 136 eyes of 136 patients with at least one leaking sclerotomy at the end of a complete 23-gauge transconjunctival sutureless vitrectomy, external bipolar wet-field diathermy was applied to leaking sclerotomies, including the conjunctiva and sclera. Intraoperative wound closure, and postoperatively, at 6 hours, 1 day and 3 days, sclerotomies leakage, intraocular pressure, hypotony, and hypotony-related complications were evaluated.
  
  
  RESULTS
  Intraoperative closure was achieved in 231 of 238 leaking sclerotomies (97%) that received diathermy. One of these with postoperative leakage needed suture. Compared with baseline (14.4 ± 2.8 mmHg), mean intraocular pressure was lower at 6 hours (13.2 ± 3.8 mmHg, Tukey-Kramer P < 0.001) and not different at 24 hours or 72 hours. Hypotony (intraocular pressure <5 mmHg) was observed in 6 eyes (4.5%) at 6 hours, in 2 (1.5%) at 24 hours, and in none at 3 days. Logistic regression analysis showed that, 6 hours postoperatively, hypotony was related to younger age (≤50 years) at surgery (P = 0.031). No hypotony-related complications were recorded.
  
  
  CONCLUSIONS
  Bipolar wet-field diathermy of sutureless sclerotomies is an effective method for ensuring a leaking sclerotomies closure.
authors.affiliation: Department of Ophthalmology, University of Catania, Catania, Italy.
authors.forename: Michele
authors.initials: M
authors.lastname: Reibaldi
authors.forename: Antonio
authors.initials: A
authors.lastname: Longo
authors.forename: Alfredo
authors.initials: A
authors.lastname: Reibaldi
authors.forename: Teresio
authors.initials: T
authors.lastname: Avitabile
authors.forename: Alfredo
authors.initials: A
authors.lastname: Pulvirenti
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Lippolis
authors.forename: Fabio
authors.initials: F
authors.lastname: Mininni
authors.forename: Maria G
authors.initials: MG
authors.lastname: La Tegola
authors.forename: Luigi
authors.initials: L
authors.lastname: Sborgia
authors.forename: Nicola
authors.initials: N
authors.lastname: Recchimurzo
authors.forename: Carlo
authors.initials: C
authors.lastname: Sborgia
authors.forename: Francesco
authors.initials: F
authors.lastname: Boscia
mesh_terms: D000368:Aged; D003228:Conjunctiva / Q000601:surgery; D003972:Diathermy / Q000379:methods*; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000517:prevention & control*; D011446:Prospective Studies; D012164:Retinal Diseases / Q000601:surgery; D012599:Sclerostomy; D014821:Vitrectomy / Q000009:adverse effects* / Q000379:methods