23 gauge vitrectomy results

Aim: In our study, analyzed the efficacy and safety of 23 G pars plana vitrectomy (PPV) in the treatment of various vitreoretinal diseases, and analyze the complications. Material and Methods: We enrolled 144 eyes of 144 patients to whom 23-gauge PPV was performed between December 2010 - August 2012. The postoperative changes of visual acuity (VA), intraocular pressure (IOP) , and complications before and after the surgery were evaluated. Indications for surgery were; rhegmatogenous retinal detachment (RRD), tractional retinal detachment (TRD), vitreous hemorrhage (VH), idiopathic macular holes (IMH), epiretinal membrane (ERM), dislocation of lens fragments and intraocular lens (IOL) into the vitreous, intraocular foreign body, vitreous opacities and endophthalmitis. Results: In our study, 76 men (52.8%) and 68 women (47.2%) for a total of 144 eyes of 144 patients were included. The mean age of the patients was 61.3 ± 13.9. Average follow-up period was 9.4 (3-19) months. There was a significant decrease of average VA at postoperative day 1 to 3 (p <0.001 and p <0.001 respectively) in comparison with preoperative VA, whereas at postoperative 1 month or at the last examination, statistically significant increases were found(p <0.001 and p <0.001 respectively). In the early period postoperative hypotony (<10 mmHg) in 4 eyes (2.8%) and hypertension (> 21 mmHg) in 29 eyes (20.1%) were detected, tempoarary choroidal detachment developed in 2 eyes (1.4%). In patients with postoperative hypertension local drops were used in 19 (%65,5), partial silicon oil extraction in seven (24,2%), glaucoma surgery (trabeculectomy in 2 eyes, 1 eye seton surgery) in three (10.3%) eyes, as a treatment. Five among 41 patients (12.1%), who had been performed surgery because of vitreous hemorrhage previously, were re-operated because of recurrent VH. In one of 42 cases with rhegmatogenous retinal detachment (2.3%) cerclage band was performed, and no recurrence were detected. Pars plana vitrectomy and phacoemulsification surgery were performed to 35 eyes (24.3%), and postoperative fibrin reaction was seen in four eyes (11.4%) in the anterior chamber. When post-operative reaction of 144 eyes in our study were evaluated, 129 (89.6%) eyes had quiet anterior chamber, in 9 eyes (6.3%) there were fibrin reaction, 3 eyes had a reaction of +1 to +4 (2.1%) in anterior chamber, three eyes (2.1%) had hypopyon. Three cases (2.1%) with postoperative hypopyon developed were considered endophthalmitis. In 25 eyes (17.4%) , sclerotomies needed to have sutures. Discussion: 23 G vitrectomy technique has been considered a safe and effective technique in the surgical treatment of vitreoretinal diseases. Due to the expanding indications and patient comfort, 23 G vitrectomy technique is a serious alternative to conventional methods of vitrectomy. In order to increase the efficiency and reliability of the surgery, the advances in the technological of and microsurgical instruments and techniques. Larger series of studies with the control groups are needed.