Intraocular pressure outcomes after 23-G vitreoretinal surgery with two different transconjunctival sutureless sclerotomy techniques: vertical versus tunnel entry

Abstract

Purpose: Comparison of postoperative intraocular pressure (IOP) course and early complications in 23-gauge (23-G) pars plana vitrectomy (PPV) using vertical entry sclerotomy and scleral tunnel sclerotomy in uncomplicated rhegmatogenous retinal detachment (RRD).

Method: A prospective, randomized, comparative, interventional clinical trial of 103 23-G vitrectomy cases using two different transconjunctival sutureless sclerotomy techniques performed by a single vitreoretinal surgeon for uncomplicated RRD. Fifty-two eyes underwent PPV using a three-port 23-G single stage, vertical trocar entry without creating a scleral tunnel (Group 1), while in 51 eyes, a two-stage, oblique trocar entry with creation of a scleral tunnel was performed (Group 2). Sulfur hexafluoride (SF6) gas (20%) was used in all cases as a buffer. Intraocular pressure measurements and detailed biomicroscopic examination of the groups were recorded on the postoperative first day, first week, and first month. Visual acuity and fundoscopic examinations were recorded at one month. The effects of the two methods on postoperative intraocular pressure and early complications were compared.

Results: There was no significant difference between the two groups in terms of age and gender (p > 0.05). The mean postoperative intraocular pressure on the first day was 15.06 ± 3.71 for Group 1 and 16.14 ± 3.09 mmHg for Group 2. The lowest recorded IOP was 6 mmHg. Postoperative visual acuity did not differ between the two groups (p > 0.05). In addition, IOP values did not differ statistically between the two groups (p > 0.05). In both groups, the mean IOP values measured at different intervals did not differ statistically (p > 0.05).

Conclusion: There was no significant difference in terms of postoperative IOP between vertical entry 23-G sclerotomy and 23-G tunnel entry sclerotomy for PPV with 20% SF6 tamponade surgery.

Keywords: Intraocular pressure and 23G vitrectomy; Rhegmatogenous retinal detachment; SF6 tamponade; Surface tension; Tunnel entry sclerotomy; Vertical sclerotomy.