Hassan Mortada (Cairo, Egypt)

Advantages:

To evaluate the efficacy of using only 23g transconjuntival sutureless vitrectomy in management of complicated retinal detachment over the past 3 years. The preservation of the integrity of the conjunctiva and sclera in these cases is of crucial importance, as these cases frequently need more than one operation, at least to remove silicone oil. This is a major advantage of 23G over 20G. The presence of the aspiration port of the 23G vitrectomy probe close to the tip allows it to replace scissors and aspiration devices in many situations. The surgery is generally faster and the postoperative recovery is shorter than with 20G system.

Methods:

263 eyes with complex RD underwent 23G transconjunctival sutureless vitrectomy, including 36 eyes with PVR, 28 eyes with giant retinal tears, 135 eyes with diabetic traction or combined traction/rhegmatogenous RD, 26 eyes with traumatic RD, 21 eyes with myopic foveoschisis and myopic macular hole RD and 17 eyes with stage 4 & 5 ROP.

Effectiveness / Safety:

All intraoperative manipulations were performed using 23G vitrectomy system. Conversion to 20G was not necessary in any case. The intraoperative and postoperative results were comparable to 20G system with the advantages of using smaller gauge instruments.

Take home message:

23G transconjunctival sutureless vitrectomy can be used effectively and safely to manage complicated forms of retinal detachment.