J Korean Ophthalmol Soc > Volume 50(3); 2009 > Article
Journal of the Korean Ophthalmological Society 2009;50(3):359-364.
DOI: https://doi.org/10.3341/jkos.2009.50.3.359    Published online March 15, 2009.
Partial Fluid-Air-Exchange at the End of 23 Gauge Sutureless Vitrectomy to Prevent Postoperative Hypotony.
Myun Ku, Hee Jin Sohn, Dae Yeong Lee, Dong Heun Nam
Department of Ophthalmology, Gachon University Gil Medical Center, Incheon, Korea. eyedawns@gilhospital.com
23게이지 무봉합 유리체절제술에서 술 후 저안압 예방을 위한 부분 액체공기교환술
구 면ㆍ손희진ㆍ이대영ㆍ남동흔
Department of Ophthalmology, Gachon University Gil Medical Center, Incheon, Korea
Abstract
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 bubble-related 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.
Key Words: Complication;Hypotony;Sutureless vitrectomy;23 Gauge


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