Comparison of Changes in Ocular Surface Status and Subjective Symptom Severity of Between Sutureless and Sutured 23-gauge Vitrectomy


Comparison of Changes in Ocular Surface Status and Subjective Symptom Severity of Between Sutureless and Sutured 23-gauge Vitrectomy by Jae Hoon Lee, Mee Yon Lee, South Korea



Dry eye-associated symptoms, such as ocular discomfort, foreign body sensation, visual disturbance, fatigue, frequently occur after refractive surgery, cataract surgery, and vitrectomy surgery. However, the follow-up of dry eye symptoms after vitrectomy surgery and analysis of correlating effect of scleotomies sites sutured has not been undertaken. Therefore, we studied changes in objective ocular surface status and subjective dry eye sympoms according to the transconjunctival suture after 23-gauge vitrectomy.


The study included 50 eyes of 50 patients who were diagnosed rhegmatogenous retinal detachment, epiretinal membrane, macular hole, vitreous hemorrhage. The patients were randomly grouped, thirty-five sutureless patients (35 eyes) and fifteen sutured patients (15 eyes) who had undergone 23-gauge transconjunctival vitrectomy were compared, from January 2016 to November 2016 were enrolled in the present study retrospectively. In each group, we measured objective values such as The tear film break-up time (TBUT), Schirmer test I, corneal surface grading with Oxford system, and subjective dry eye symptom using ocular surface disease index (OSDI) questionnaire were performed pre-opeatively and 1 week, 1 and 3 months after surgery were evaluated.


TBUT were shorter and Schirmer test I were worse with sutured group than suturless group at 3 months after surgery group (p = 0.026, p=0.036). But there was no difference in TBUT and Schirmer test I according to the suture at postoperative 1 week and 1 month (p>0.05). There were no statistically significant differences according to corneal surface staining score between sutured group and sutureless group at any postoperative time points (p>0.05). The OSDI score was significantly worse with the sutured group than with the sutureless group at 1week, 1 and 3 months after surgery (p=0.041, p=0.032, p=0.026).


23-gauge transconjunctival sutureless techniques cause less or no surgical trauma to the conjunctiva, no sclera suturing, and cause less postoperative discomfort. Compared to transconjunctival sutured techniques, transconjunctival sutureless techniques has long term advantages at obsective test, such as TBUT and Schirmer test I. The major advantage of transconjunctival sutureless techniques has subjective symtoms were improved at any postoperative times, compare to transconjunctival sutured techniques.



Jae Hoon Lee
Seoul, South Korea
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