title: SCLEROTOMY LEAKAGE IN TRANSCONJUNCTIVAL SMALL-GAUGE PARS PLANA VITRECTOMY: Effect of Removing the Cannula Over the Light Pipe.
abstract: OBJECTIVE
  To determine the effect of cannula removal over the light pipe on the incidence of sclerotomy leakage and to evaluate other factors that may influence the incidence of sclerotomy leaks and hypotony on conclusion of small-gauge transconjunctival pars plana vitrectomy.
  
  
  METHODS
  Retrospective, interventional clinical study of consecutive patients who underwent small-gauge transconjunctival pars plana vitrectomy at a single academic center. Eyes were divided into a group in which cannulae were removed over the light pipe (Group L) and a group in which cannulae were simply pulled out (Group N). The primary comparison was the comparison in requirement for suturing of sclerotomies between Groups L and N.
  
  
  RESULTS
  Forty-eight eyes of 48 patients were included in the study (Group L: 21 eyes; Group N: 27 eyes). In Group L, 14/42 (33%) superior sclerotomies required suturing compared with 7/54 (13%) sclerotomies in Group N (P = 0.024). Superior sclerotomy leaks were also more common in Group L (28/42, 67%) compared with Group N (23/54, 43%, P = 0.024). Similarly, more eyes had hypotony after cannula removal in Group L (11/21; 52%) compared with Group N (5/27; 19%, P = 0.03). There were no differences in any of these measures when comparing fluid-filled to air- or gas-filled eyes.
  
  
  CONCLUSIONS
  Removing the cannula over the light pipe results in a greater frequency of leaking, including leaking that results in hypotony or that requires suturing. The technique of cannula removal affects the risk of leakage and the risk of requiring suturing of a sclerotomy.
authors.affiliation: *Piedmont Eye Center, Lynchburg, Virginia; †Robert Cizik Eye Clinic, Houston, Texas; ‡Department of Ophthalmology, Mayo Clinic, Rochester, Minnesota; §Retina Consultants P.C., Bethesda, Maryland; ¶Cullen Eye Institute, Baylor College of Medicine, Houston, Texas; and **Department of Ophthalmology, The George Washington University, Washington, District of Columbia.
authors.forename: Golnaz
authors.initials: G
authors.lastname: Javey
authors.forename: Mohammed
authors.initials: M
authors.lastname: Rigi
authors.forename: Andrew J
authors.initials: AJ
authors.lastname: Barkmeier
authors.forename: Jordan L
authors.initials: JL
authors.lastname: Heffez
authors.forename: Petros E
authors.initials: PE
authors.lastname: Carvounis
mesh_terms: D000072601:Cannula / Q000009:adverse effects*; D003228:Conjunctiva / Q000601:surgery; D020878:Device Removal / Q000009:adverse effects*; D004868:Equipment Failure; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007431:Intraoperative Complications / Q000453:epidemiology*; D011183:Postoperative Complications / Q000453:epidemiology*; D012189:Retrospective Studies; D012590:Sclera / Q000601:surgery; D012599:Sclerostomy / Q000009:adverse effects* / Q000295:instrumentation; D014481:United States / Q000453:epidemiology; D014821:Vitrectomy / Q000379:methods*