title: Comparison of 23-gauge sutureless sclerotomy architecture and clinical outcomes in macular and non-macular surgery using spectral-domain optical coherence tomography.
abstract: OBJECTIVE
  To compare the 23-gauge (23-G) sutureless vitrectomy incision architecture in macular and non-macular surgery, using anterior segment spectral-domain optical coherence tomography (SD-OCT), and to evaluated its influence on clinical outcomes.
  
  
  METHODS
  A prospective, observational case series of 43 patients who underwent primary transconjunctival 23-G pars plana vitrectomy (PPV) for macular and non-macular diseases. All sclerotomy wounds were imaged 1 day after surgery using the anterior segment module of SD-OCT (OCT Spectralis; Heidelberg Engineering, Heidelberg, Germany). Sclerotomy architecture, including good wound apposition, presence of gaping and misalignment of the roof and floor of the incisions were evaluated. Preoperative, intraoperative and postoperative medical record data were also prospectively collected.
  
  
  RESULTS
  Incision gaping and misalignment of the roof and floor occurred more frequently in the superotemporal and superonasal quadrants than in the inferotemporal quadrant (p < 0.05) and was more frequent in the non-macular group than in the macular group (p < 0.05). The incidence of incision gaping increased significantly as the incision angle increased. In the macular group, the mean postoperative intraocular pressure (IOP) did not change from the preoperative value, whereas in the non-macular group, the mean IOP decreased significantly from 15.09 ± 2.58 mmHg preoperatively to 12.18 ± 3.25 mmHg on the first postoperative day (p < 0.005). The mean IOP did not differ significantly between the two groups of surgery at 1 week, and at 1 month postoperatively.
  
  
  CONCLUSIONS
  In 23-G PPV, non-macular surgery is associated with a significant postoperative IOP decrease in comparison with macular surgery, which could be explained by the most remodelled wound architecture.
authors.affiliation: Department of Ophthalmology II, Quinze-Vingts National Ophthalmology Hospital, Paris, France. tjhr78@hotmail.com
authors.forename: Rachid
authors.initials: R
authors.lastname: Tahiri Joutei Hassani
authors.forename: Mohamed
authors.initials: M
authors.lastname: El Sanharawi
authors.forename: Raphael
authors.initials: R
authors.lastname: Adam
authors.forename: Claire
authors.initials: C
authors.lastname: Monin
authors.forename: Sylvère
authors.initials: S
authors.lastname: Dupont-Monod
authors.forename: Christophe
authors.initials: C
authors.lastname: Baudouin
mesh_terms: D000368:Aged; D005260:Female; D006801:Humans; D007429:Intraocular Pressure / Q000502:physiology; D008297:Male; D008866:Microsurgery; D008875:Middle Aged; D011446:Prospective Studies; D012164:Retinal Diseases / Q000601:surgery*; D012590:Sclera / Q000473:pathology*; D012599:Sclerostomy; D013536:Suture Techniques; D041623:Tomography, Optical Coherence; D016896:Treatment Outcome; D014792:Visual Acuity / Q000502:physiology; D014821:Vitrectomy