Document Detail

Comparison of 23-gauge sutureless sclerotomy architecture and clinical outcomes in macular and non-macular surgery using spectral-domain optical coherence tomography.
MedLine Citation:
PMID:  23280085     Owner:  NLM     Status:  MEDLINE    
PURPOSE: To compare the 23-gauge (23-G) sutureless vitrectomy incision architecture in macular and non-macular surgery, using anterior segment spectral-domain optical coherence tomography (SD-OCT), and to evaluated its influence on clinical outcomes.
METHODS: A prospective, observational case series of 43 patients who underwent primary transconjunctival 23-G pars plana vitrectomy (PPV) for macular and non-macular diseases. All sclerotomy wounds were imaged 1 day after surgery using the anterior segment module of SD-OCT (OCT Spectralis; Heidelberg Engineering, Heidelberg, Germany). Sclerotomy architecture, including good wound apposition, presence of gaping and misalignment of the roof and floor of the incisions were evaluated. Preoperative, intraoperative and postoperative medical record data were also prospectively collected.
RESULTS:   Incision gaping and misalignment of the roof and floor occurred more frequently in the superotemporal and superonasal quadrants than in the inferotemporal quadrant (p < 0.05) and was more frequent in the non-macular group than in the macular group (p < 0.05). The incidence of incision gaping increased significantly as the incision angle increased. In the macular group, the mean postoperative intraocular pressure (IOP) did not change from the preoperative value, whereas in the non-macular group, the mean IOP decreased significantly from 15.09 ± 2.58 mmHg preoperatively to 12.18 ± 3.25 mmHg on the first postoperative day (p < 0.005). The mean IOP did not differ significantly between the two groups of surgery at 1 week, and at 1 month postoperatively.
CONCLUSIONS:   In 23-G PPV, non-macular surgery is associated with a significant postoperative IOP decrease in comparison with macular surgery, which could be explained by the most remodelled wound architecture.
Rachid Tahiri Joutei Hassani; Mohamed El Sanharawi; Raphael Adam; Claire Monin; Sylvère Dupont-Monod; Christophe Baudouin
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Publication Detail:
Type:  Comparative Study; Journal Article     Date:  2012-12-31
Journal Detail:
Title:  Acta ophthalmologica     Volume:  91     ISSN:  1755-3768     ISO Abbreviation:  Acta Ophthalmol     Publication Date:  2013 May 
Date Detail:
Created Date:  2013-04-17     Completed Date:  2013-09-05     Revised Date:  2014-07-31    
Medline Journal Info:
Nlm Unique ID:  101468102     Medline TA:  Acta Ophthalmol     Country:  England    
Other Details:
Languages:  eng     Pagination:  e203-10     Citation Subset:  IM    
Copyright Information:
© 2012 The Authors. Acta Ophthalmologica © 2012 Acta Ophthalmologica Scandinavica Foundation.
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MeSH Terms
Intraocular Pressure / physiology
Middle Aged
Prospective Studies
Retinal Diseases / surgery*
Sclera / pathology*
Suture Techniques*
Tomography, Optical Coherence*
Treatment Outcome
Visual Acuity / physiology

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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