23게이지 유리체절제술시 23게이지 주사바늘을 이용한 공막절개의 임상 결과

Clinical Results of 23-gauge Sclerotomy using 23-gauge Needle during 23-gauge Vitrectomy

Purpose: To report the clinical results of 23-gauge sclerotomy using 23-gauge needle during 23- gauge vitrectomy. Methods: A retrospective review was conducted on 331 eyes underwent 23-gauge sclerotomy using 23-gauge needle during vitrectomy from April 5th, 2011 to January 14th, 2013. All sclerotomy wounds were sutured with 8-0 vicryl at the end of the surgery. The main outcome measures included changes in best corrected visual acuity (BCVA), intraocular pressure (IOP), corneal astigmatism, and presence of intraoperative, postoperative complications after surgery. Results: The mean preoperative logMAR BCVA improved from 0.92 ± 0.76 to 0.43 ± 0.36 at 3 months after surgery (p<0.05). There was no significant difference between the mean preoperative IOP and IOP on the 3 months after surgery (p>0.05). There was no clinically significant change in the mean corneal astigmatism 2 weeks after surgery (p>0.05). Intraoperative complications had conjunctival incision due to conjunctival chemosis in 24 eyes, choroidal detachment in 2 eyes, retinal tear in 11 eyes. Postoperative complications included increased IOP in 29 eyes, hypotony in 1 eye, recurrent vitreous hemorrhage in 6 eyes, proliferative vitreoretinopathy in 1 eye, and subfoveal perfluorocarbon liquid in 1 eye. Mild foreign body sensation due to conjunctival sutures was noted, but most cases were improved at 1 to 4 weeks after surgery. However, there were no severe postoperative complications such as retinal detachment or endophthalmitis. Conclusions: 23-gauge sclerotomy using 23-gauge needle during vitrectomy is safe without serious complications postoperatively and also cost effective.