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Perioperative changes of the intraocular pressure during the treatment of epiretinal membrane by using 25- or 27-gauge sutureless vitrectomy without gas tamponade

Authors Takashina H, Watanabe A, Tsuneoka H

Received 2 February 2017

Accepted for publication 30 March 2017

Published 19 April 2017 Volume 2017:11 Pages 739—743

DOI https://doi.org/10.2147/OPTH.S133775

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Colin Mak

Peer reviewer comments 4

Editor who approved publication: Dr Scott Fraser

Hirotsugu Takashina,1,2 Akira Watanabe,2 Hiroshi Tsuneoka2

1
Department of Ophthalmology, National Hospital Organization Sagamihara Hospital, 2Department of Ophthalmology, Jikei University School of Medicine, Tokyo, Japan

Purpose: The purpose of this study was to compare perioperative intraocular pressures (IOPs) in 25- or 27-gauge microincision vitrectomy surgery (MIVS) and to evaluate the stability of postoperative sclerotomy closure.
Materials and methods:
This is a retrospective review of 147 eyes treated for epiretinal membrane by using 25- or 27-gauge MIVS as the initial vitrectomy (25-gauge phacovitrectomy [25-P group]: 73 eyes, 25-gauge vitrectomy alone [25-A group]: 15 eyes, 27-gauge phacovitrectomy [27-P group]: 47 eyes, and 27-gauge vitrectomy alone [27-A group]: 12 eyes). Statistical analyses of perioperative IOPs on preoperative day (PreOp), postoperative day (POD)1, POD2, postoperative week 1, and postoperative month 1 were performed.
Results:
All self-sealing sclerotomies were obtained without gas tamponade at the end of surgery. Also, no significant differences were noted in the age and axial length among the 4 groups and in the surgical time between 25-P and 27-P groups and between 25-A and 27-A groups. Significant decreases in IOP were found at POD1 and POD2 in the 25-P, 25-A, and 27-P groups compared with PreOP, but not in the 27-A group.
Conclusion:
Even though surgeons confirm that there is no leakage from sutureless sclerotomy and that a normal IOP is preserved at the end of 25- or 27-gauge MIVS, there is a possibility of postoperative sclerotomy leakage on the day of the surgery. Furthermore, postoperative sclerotomy self-sealing of the MIVS in previous intraocular lens implantation cases is considered to be acquired easily than that in phacovitrectomy.

Keywords:
self-sealing, sclerotomy, leakage, remnant vitreous, ciliochoroidal detachment, microincision, phacovitrectomy

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