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KMID : 0360220090500030359
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Journal of the Korean Ophthalmological Society
2009 Volume.50 No. 3 p.359 ~ p.364
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Partial Fluid-Air-Exchange at the End of 23 Gauge Sutureless Vitrectomy to Prevent Postoperative Hypotony
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Ku Myun
Sohn Hee-Jin
Lee Dae-Yeong
Nam Dong-Heun
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Abstract
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Purpose: To evaluate the efficacy and safety of partial fluid air exchange at the end of 23-gauge transconjunctival sutureless vitrectomy to prevent postoperative hypotony.
Methods: Fifty-five eyes in 49 consecutive patients who underwent partial fluid air exchange at the end of 23-gauge sutureless vitrectomy by a single surgeon at Gil Hospital between August 2007 and February 2008 were recruited for this study. Intraocular pressure (IOP), visual acuity and post-operative complications were evaluated.
Results: Surgical indications included proliferative diabetic retinopathy (n=31), epiretinal membrane (n=9), nondiabetic vitreous hemorrhage (n=5), vitreous opacities (n=3), and others (n=7). Two eyes showed hypotony (<6 mmHg) on postoperative day 1 and resolved within a week without any supplemental procedures. Other complications included choroidal detachment in 1 eye, hyphema in 1 eye, and transient IIOP in 2 eyes. In 38 eyes in which combined cataract surgery was performed, air bubblerelated complications including iris capture by the IOL in 3 eyes (7.9%) and opacification of the posterior capsule in 11 eyes (28.9%) occurred. No case of retinal detachment or endophthalmitis was observed. The final best corrected visual acuity was 20/40 or better in 14 eyes (25.5%).
Conclusions: The partial fluid air exchange shows promise as an effective and safe procedure for prevention of postoperative hypotony after sutureless vitrectomy. Air bubble-related complications after combined cataract surgery can be avoided by several techniques.
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KEYWORD
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Complication, Hypotony, Sutureless vitrectomy, 23 Gauge
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