title: 27-GAUGE VITRECTOMY WOUND INTEGRITY: A Randomized Pilot Study Comparing Angled Versus Straight Entry in Fluid-Filled Vitrectomized Eyes.
abstract: OBJECTIVE
  To compare clinical outcomes using angled versus straight trocar insertion during 27-gauge pars plana vitrectomy for epiretinal membrane.
  
  
  METHODS
  Pilot randomized controlled trial. Thirty eyes of 30 patients undergoing 27-gauge pars plana vitrectomy with membrane peeling for epiretinal membrane were randomized 1:1 to receive angled or straight trocar insertion. Intraocular pressure (IOP) and postoperative wound-related complications were compared.
  
  
  RESULTS
  Fifteen eyes were randomized to each the angled and straight incision groups. No significant difference in phakic status (P = 0.71) or preoperative IOP (15.1 ± 3.4 vs. 14.6 ± 3.0 mmHg, P = 0.67) existed between groups. On postoperative Day 1, eyes in the straight group had lower IOP compared with the angled group (11.8 ± 3.9 vs. 15.3 ± 5.2 mmHg, P = 0.04) and a relative decrease in IOP compared with preoperative values (11.8 ± 3.9 vs. 15.1 ± 3.4 mmHg, P < 0.01). No IOP difference between groups was present at Day 7 (P = 0.43) or Day 30 (P = 0.42). Postoperative complications included transient hypotony (1 eye, straight group) and serous choroidal detachment (1 eye, angled group).
  
  
  CONCLUSIONS
  Eyes with straight incisions had transiently lower IOP on postoperative Day 1, possibly suggestive of subclinical wound leak in the very early postoperative period. Overall, rates of hypotony and sclerotomy-related complications were similarly low between wound construction strategies.
authors.affiliation: Retina Service, Wills Eye Hospital, Mid-Atlantic Retina, Sidney Kimmel Medical College, Philadelphia, Pennsylvania.|Retina Division, Doheny and Stein Eye Institutes, David Geffen School of Medicine at UCLA, Pasadena, California.
authors.forename: M Ali
authors.initials: MA
authors.lastname: Khan
authors.affiliation: Retina Service, Wills Eye Hospital, Mid-Atlantic Retina, Sidney Kimmel Medical College, Philadelphia, Pennsylvania.
authors.forename: Alia K
authors.initials: AK
authors.lastname: Durrani
authors.affiliation: Retina Service, Wills Eye Hospital, Mid-Atlantic Retina, Sidney Kimmel Medical College, Philadelphia, Pennsylvania.
authors.forename: Jason
authors.initials: J
authors.lastname: Hsu
authors.affiliation: Retina Service, Wills Eye Hospital, Mid-Atlantic Retina, Sidney Kimmel Medical College, Philadelphia, Pennsylvania.
authors.forename: Carl D
authors.initials: CD
authors.lastname: Regillo
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019773:Epiretinal Membrane / Q000601:surgery*; D005260:Female; D006801:Humans; D007429:Intraocular Pressure; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D012590:Sclera / Q000601:surgery; D014792:Visual Acuity; D014821:Vitrectomy / Q000379:methods*