Hulya Gungel, Deniz Oygar Baylancicek, Isil Basgil, Nihat Sayin, Eylem Yaman Pinarci

Purpose:

To evaluate the anatomic and visual outcomes of 23-gauge transconjunctival sutureless vitrectomy for a variety of vitreoretinal conditions in patients with diabetic retinopathy.

Methods:

A retrospective, consecutive, interventional case series for 21 eyes of 20 patients with proliferative diabetic retinopathy. Patients underwent vitreoretinal surgery using a 3-port 23 gauge transconjunctival sutureless vitrectomy system by the same vitreoretinal surgeon. There were various posterior segment conditions including vitreous hemorrhage in 12 cases, diabetic tractional retinal detachment in 8 cases and vitreomacular traction syndrome in 1 case. At the end of the procedure silicone oil in 13 eyes, air in 7 eyes and SF6 in 1 eye were used as tamponades. All patients were performed intravitreal bevacizumab injection 1 week before surgery. Main outcome measures were visual acuity, intraocular pressure, intra- and post-operative complications.

Results:

Patients with a mean age of 55,57 years, 10 female and 11 male were included in our study. Mean follow up period was 5,2 months. Preoperative visual acuity was improved from hand motion (LogMAR 2,3 +/- 0,8) to 20/400 snellen unit (LogMAR 1,9 +/- 1,06). Mean intraocular pressure on the first postoperative day was 16,45 mmHg, there were no cases of postoperative hypotony and none of the eyes had leakage of silicone oil through the sclerotomies. There was a single case of intraoperative complication that silicone tip of 23 gauge trochar dropped into retina. Retinal re-detachment was detected in 2 patients who underwent a second surgical procedure.Silicone oil and C3F8 gas tamponades were used respectively. At the end of 5 months follow up period, there were 9 eyes with silicone oil tamponade, and 4 eyes with silicone oil removal.

Conclusion:

The 23-gauge TSV system is an effective, safe and minimally invasive technique for treating various posterior segment conditions in diabetic retinopathy.