Retina-Vitreous
2011 , Vol 19 , Num 2
Comparison of Silicone Oil Removal Using 23 Gauge and 20 Gauge Sclerotomy Systems
1İnönü Üniversitesi Turgut Özal Tıp Merkezi, Göz Hastalıkları A.D., Malatya, Prof. Dr.2İnönü Üniversitesi Turgut Özal Tıp Merkezi, Göz Hastalıkları A.D., Malatya, Uzm. Dr.
3Malatya Devlet Hastanesi, Göz Hastalıkları Servisi, Malatya, Uzm. Dr.
4İnönü Üniversitesi Turgut Özal Tıp Merkezi, Göz Hastalıkları A.D., Malatya, Yrd. Doç. Dr. Purpose: To compare 23 and 20 Gauge (G) sclerotomy methods for silicone oil removal.
Materials and Methods: Patients that had undergone pars plana vitrectomy (PPV) and received silicone oil as intraocular tamponade material because of retinal detachment and the complications of proliferative diabetic retinopathy were divided into two groups: those undergoing removal of silicone oil through 20 G sclerotomy (Group 1; 39 patients) and those undergoing removal of silicone oil through 23 G transconjunctival sclerotomies (Group 2; 34 patients). The groups were evaluated with regard to postoperative changes in BCVA and IOP, and complications that occurred during and after surgery.
Results: In the postoperative follow-up, the mean values of BCVA on the first day, at the first week, and at the first, third, and sixth months were LogMAR 1.2±1.0, 1.0±1.0, 0.96±0.9, 0.9±0.85, and 0.86±0.8, respectively, in Group 1, and LogMAR 1.2±1.2, 0.96±1.0, 0.94±0.9, 0.9±0.94, and 0.9±0.94, respectively, in Group 2. In the postoperative follow-up, the mean values of IOP on the first day, at the first week, and at the first, third, and sixth months were 13±1.7, 14±2.6, 14±1.7, 14±1.6, and 15±3.2 mmHg, respectively, in Group 1, and 11±3.5, 12±1.8, 13±1.8, 13±2.0, and 14±2.6 mmHg, respectively, in Group 2. No patients from the Group 1 developed hypotonia on the first day after surgery, whereas hypotonia was determined in 3 patients (8.8%) from Group 2. During the postoperative checkups, re-detachment was found in 4 patients (10.2%) from Group 1, recurring vitreous hemorrhage (VH) was found in 3 patients (7.6%) from Group 1, re-detachment occurred in 2 patients (5.8%) from Group 2, and recurring VH occurred in 2 patients (5.8%) from Group 2.
Conclusion: Silicone oil removal using a 23 G transconjunctival sutureless pars plana vitrectomy and the 20 G pars plana vitrectomy system shows similar characteristics. However, the 23 G transconjunctival system provides additional benefits such as the advantages of a closed system, the conjunctiva is not opened, and the complications due to the sutures are reduced. Keywords : 20 G pars plana vitrectomy system, 23 G transconjunctival sutureless pars plana vitrectomy, Silicone oil removal