title: Influence of incisional vitreous incarceration in sclerotomy closure competency after transconjunctival sutureless vitrectomy.
abstract: OBJECTIVE
  To evaluate the influence that vitreous incarceration may exert on the presence of postoperative conjunctival blebs over sclerotomies after transconjunctival sutureless vitrectomy (TSV). Blebs are formed by incisional leakage due to incompetent closure.
  
  
  METHODS
  Experimental study in which 23-gauge TSV was performed in 146 cadaveric pig eyes. Once the vitrectomy was finished, triamcinolone was injected inside the vitreous cavity for staining residual vitreous, one of the superior cannulas was extracted over the light probe, and the other cannula was removed with the plug inserted. Postoperative conjunctival blebs in superior sclerotomies were assessed by anterior-segment optical coherence tomography (AS-OCT) in a masked fashion; nondetectable blebs were classified as grade 0 (B0), thin bleb (≤half scleral thickness) as grade 1 (B1), and thick bleb (>half scleral thickness) as grade 2 (B2). Postoperative incisional vitreous entrapment was evaluated by slit-lamp photographs in a masked way; no incarceration was classified as grade 0 (V0), thin incarceration as grade 1 (V1), and thick incarceration as grade 2 (V2).
  
  
  RESULTS
  Conjunctival blebs were found in 13.7% of the sclerotomies (11.3% bleb-B1, 2.4% bleb-B2). Vitreous incarceration was found in 96.5% of the sclerotomies without bleb (B0), 81.8% of the incisions with bleb-B1, and 14.3% of the wounds with bleb-B2. Vitreous incarceration was significantly associated with the absence of conjunctival bleb (P < 0.001).
  
  
  CONCLUSIONS
  Vitreous incarceration in sclerotomies is related to less incisional leakage in our experimental model. Maneuvers that reduce vitreous entrapment, such as the interposition of a nonhollow probe during the cannula extraction, could decrease the sclerotomy closure competency.
authors: Department of Ophthalmology, University Hospital Principe de Asturias, Alcalá de Henares (Madrid), Spain.
authors: Javier
authors: J
authors: Benitez-Herreros
authors: Lorenzo
authors: L
authors: Lopez-Guajardo
authors: Cristina
authors: C
authors: Camara-Gonzalez
authors: Aurora
authors: A
authors: Perez-Crespo
authors: Agustin
authors: A
authors: Silva-Mato
authors: Alejandro
authors: A
authors: Alvaro-Meca
authors: Miguel A
authors: MA
authors: Teus
mesh_terms: D000818:Animals; D001768:Blister / Q000517:prevention & control; D002404:Catheterization / Q000379:methods; D003228:Conjunctiva / Q000601:surgery*; D003229:Conjunctival Diseases / Q000517:prevention & control; D023421:Models, Animal; D011183:Postoperative Complications / Q000517:prevention & control*; D012590:Sclera / Q000601:surgery; D012599:Sclerostomy / Q000379:methods*; D034421:Sus scrofa; D013536:Suture Techniques; D014821:Vitrectomy / Q000379:methods*; D014822:Vitreous Body / Q000601:surgery*; D058106:Wound Closure Techniques
keywords: conjunctival bleb; experimental model; sclerotomy closure; vitrectomy; vitreous incarceration