title: Changes in day 1 post-operative intraocular pressure following sutureless 23-gauge and conventional 20-gauge pars plana vitrectomy.
abstract: OBJECTIVE
  The benefits associated with transconjunctival sutureless vitrectomy techniques are continuing to be defined. The purpose of this study was to compare the incidence of extreme changes in day 1 intraocular pressure (IOP) following 23-gauge sutureless vitrectomy compared with conventional 20-gauge vitrectomy.
  
  
  METHODS
  Fifty consecutive 23-gauge and 50 consecutive 20-gauge cases were included; eyes with a history of previous vitreoretinal surgery were excluded. 23-gauge surgery was completed with passive fluid air exchange where no long acting tamponade was indicated. The surgery remained sutureless unless a leak was visible at the end of the procedure. Data were collected by retrospective case note review. Statistical analysis was carried out using Fisher's exact and chi-square tests.
  
  
  RESULTS
  Twenty-two percent (11/50) of 23-gauge vitrectomies required suturing of one or more ports. On the first post-operative day hypotony (IOP<5mmHg) occurred in 1/50 eyes in the 20- and 23-gauge groups. Raised pressure (IOP>21mmHg) occurred in 30% (15/50) of eyes in the 20-gauge group and 8% (4/50) of eyes in the 23-gauge group; IOP>30mmHg only occurred in the 20-gauge group (3/50).
  
  
  CONCLUSIONS
  Fluid air exchange following 23-gauge vitrectomy is associated with very low risk of day 1 hypotony. This predominantly sutureless technique appears to reduce the incidence and magnitude of early post-operative IOP elevation compared with conventional 20-gauge vitrectomy.
authors.affiliation: Department of Ophthalmology, St Mary's Hospital, Newport, Isle of Wight, UK.
authors.forename: Emily
authors.initials: E
authors.lastname: Gosse
authors.forename: Richard
authors.initials: R
authors.lastname: Newsom
authors.forename: Peter
authors.initials: P
authors.lastname: Hall
authors.forename: Jonathan
authors.initials: J
authors.lastname: Lochhead
keywords: 23-gauge vitrectomy; Transconjunctival sutureless vitrectomy; post-operative IOP.; post-operative hypotony