A novel technique for securing Sclerotomies in 20-gauge Transconjunctival pars Plana Vitrectomy

Purpose: To describe a novel technique for securing sclerotomies after 20-gauge transconjunctival pars plana vitrectomy and determine the efficacy, and short-term safety in various vitreoretinal diseases. Methods: Retrospective chart review of consecutive cases that underwent 20-gauge transconjunctival pars plana vitrectomy with sclerotomy hydration was conducted. The main outcome measures included intraocular pressure, intraocular gas bubble size in postoperative Day 1, and early postoperative complications. Secondary outcomes included postoperative visual acuity at 1-month postoperative visit. Results: Five hundred and twenty-nine eyes were evaluated. Mean gas/air fill and mean intraocular pressure were 75.1% and 14.8 mmHg on postoperative Day 1. Seven eyes (1.32%) had hypotony (intraocular pressure <6 mmHg) on Day 1, which normalized in all eyes by Day 7 (P 0.0083). On postoperative Day 7, mean intraocular pressure was 17.1 mmHg. Hypotony was associated with a preoperative diagnosis of retinal detachment (P 0.022), and silicone oil tamponade (P 0.017). Mean best corrected visual acuity was 20/320 preoperatively and 20/125 postoperatively at 1-month follow-up visit (P < 0.0001). Twenty-seven cases had intraoperative or postoperative complications (5.1%). Rate of complications was not associated with the type of tamponade (P 0.076). Conclusion: Twenty-gauge transconjunctival sutureless vitrectomy with sclerotomy hydration appears to be safe with a low rate of hypotony and complications, and good final visual outcome.