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  • Title: Risk factors associated with sclerotomy leakage and postoperative hypotony after 23-gauge transconjunctival sutureless vitrectomy.
    Author: Woo SJ, Park KH, Hwang JM, Kim JH, Yu YS, Chung H.
    Journal: Retina; 2009 Apr; 29(4):456-63. PubMed ID: 19174725.
    Abstract:
    PURPOSE: To investigate the incidence and risk factors of sclertomy leakage and postoperative hypotony after 23-gauge transconjunctival sutureless vitrectomy. METHODS: This was a retrospective study including 322 eyes of 292 patients who underwent 23-gauge transconjunctival sutureless vitrectomy by a single surgeon with minimum follow-up period of 1 month. The incidence and risk factors of intraoperative suture placement for leaking sclerotomies and postoperative hypotony (</=5 mmHg) were analyzed in association with seven clinical factors. RESULTS: Intraoperative suture placement was required for leaking sclerotomies in 36 cases (11.2%) and was related to prior vitrectomy (OR = 7.5), young age (<50 years) at operation (OR = 4.9), and vitreous base dissection (OR = 3.5). The incidences of postoperative hypotony were 11.3% at 2 hours, 6.5% at 5 hours, 3.8% at 1 day, and 0% at 1 week. Myopia and gas tamponade were associated with early postoperative hypotony. No complications developed related to sclerotomy leakage or postoperative hypotony. CONCLUSIONS: The risk factors of intraoperative sclerotomy leakage requiring suture placement after 23-gauge transconjunctival sutureless vitrectomy are prior vitrectomy, a young age at operation, and vitreous base dissection. Caution should be exercised to ensure the detection of sclerotomy leakage and hypotony in cases with these risk factors.
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