title: Influence of the source of incisional vitreous incarceration on sclerotomy closure competency after transconjunctival sutureless vitrectomy.
abstract: OBJECTIVE
  To evaluate the influence that the origin of incisional vitreous incarceration may have 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
  Twenty-three-gauge TSV was performed in 83 cadaveric pig eyes. Once each vitrectomy was finished, ultrasound biomicroscopy (UBM) was used to assess the presence of postoperative conjunctival blebs over the sclerotomy sites, as well as the existence of vitreous incarcerated in incisions. Vitreous strands may come from the perisclerotomy area, running parallel to the sclera toward the inner hole of the sclerotomies, or may radiate from the core of the vitreous cavity.
  
  
  RESULTS
  Vitreous entrapment was found in 73.9% of the sclerotomies; 43.4% of the incisions showed vitreous strands coming parallel to the sclera (12.9% of them showed conjunctival bleb), 19.7% of the wounds presented vitreous aiming toward the core of the vitreous cavity (2% of them had conjunctival bleb) and 10.8% of the entrances presented both vitreous incarceration sources (none of them showed bleb). Incisions with vitreous entrapment parallel to the sclera were associated with a significantly greater sclerotomy leakage rate.
  
  
  CONCLUSIONS
  Sclerotomies with vitreous incarceration coming from the core of the vitreous cavity showed a greater incisional closure competency than that observed in incisions with vitreous entrapment coming from the pericannular area; if these results were confirmed in humans, different postoperative suture rates may be expected on sclerotomies according to the vitrectomy degree performed in different areas of the vitreous cavity.
authors.affiliation: Department of Ophthalmology, University Hospital Principe de Asturias , Madrid , Spain .
authors.forename: Javier
authors.initials: J
authors.lastname: Benitez-Herreros
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Lopez-Guajardo
authors.forename: Cristina
authors.initials: C
authors.lastname: Camara-Gonzalez
authors.forename: Aurora
authors.initials: A
authors.lastname: Perez-Crespo
authors.forename: Miguel
authors.initials: M
authors.lastname: Vazquez-Blanco
authors.forename: Agustin
authors.initials: A
authors.lastname: Silva-Mato
mesh_terms: D000818:Animals; D003228:Conjunctiva / Q000000981:diagnostic imaging / Q000601:surgery*; D004195:Disease Models, Animal; D005128:Eye Diseases / Q000000981:diagnostic imaging / Q000209:etiology*; D033401:Microscopy, Acoustic; D012590:Sclera / Q000601:surgery*; D012599:Sclerostomy / Q000379:methods*; D034421:Sus scrofa; D013536:Suture Techniques; D014821:Vitrectomy / Q000379:methods*; D014822:Vitreous Body / Q000473:pathology* / Q000601:surgery
keywords: Conjunctival bleb; experimental model; sclerotomy competency; vitrectomy; vitreous incarceration origin