title: [Sclerotomies analysis using Spectral Domain OCT in sutureless vitrectomies complicated by endophthalmitis].
abstract: BACKGROUND
  Transconjunctival sutureless vitrectomy is a recent advance in vitreoretinal surgery. Some authors have reported an increased risk of postoperative hypotony and endophthalmitis and recommend the creation of oblique incisions, intended to be self-sealing, so as to reduce these risks. However, there is still a debate about the best architecture for transconjunctival sutureless incisions.
  
  
  METHODS
  We report two cases of acute endophthalmitis occurring after 23 and 25 gauge transconjunctival sutureless vitrectomy. We analyzed the scleral incisions using the anterior segment module of the Spectralis(®) OCT. To our knowledge, this is the first direct description of the appearance of sclerotomies associated with endophthalmitis.
  
  
  RESULTS
  The anterior segment module of Spectralis(®) OCT permitted a high-resolution evaluation of the architecture of the scleral incisions. We found straight, gaping incisions with misaligned edges and vitreous incarceration.
  
  
  CONCLUSIONS
  By way of these two case reports and a review of the literature, we discuss the contribution of anterior segment OCT in the analysis of scleral incision architecture in sutureless vitrectomy. Our findings are consistent with those reported in the literature. The presence of a direct incision, wound gap or edge misalignment are associated with an increased risk of early leakage and postoperative hypotony.
  
  
  CONCLUSIONS
  The anterior segment module of the Spectralis(®) OCT is a valuable tool for non-invasive, painless and high-resolution documentation of sutureless vitrectomy incisions. It allows for causal analysis and better understanding of the conditions associated with endophthalmitis after sutureless vitrectomy.
authors.affiliation: Service d'ophtalmologie II, centre hospitalier national ophtalmologique des XV-XX, 28, rue de Charenton, 75012 Paris, France.
authors.forename: R
authors.initials: R
authors.lastname: Tahiri Joutei Hassani
authors.forename: R
authors.initials: R
authors.lastname: Adam
authors.forename: M
authors.initials: M
authors.lastname: El Sanharawi
authors.forename: J-P
authors.initials: JP
authors.lastname: Nordmann
authors.forename: C
authors.initials: C
authors.lastname: Baudouin
mesh_terms: D000368:Aged; D009877:Endophthalmitis / Q000175:diagnosis* / Q000209:etiology* / Q000601:surgery; D005260:Female; D006801:Humans; D011183:Postoperative Complications / Q000175:diagnosis / Q000209:etiology / Q000601:surgery; D012599:Sclerostomy / Q000379:methods*; D013537:Sutures; D041623:Tomography, Optical Coherence / Q000379:methods; D014821:Vitrectomy / Q000009:adverse effects* / Q000379:methods; D058106:Wound Closure Techniques / Q000009:adverse effects