23-Gauge Transconjunctival Sutureless Vitrectomy: Visual Outcomes and Complications

Purpose: To report results and complications of 23-gauge transconjunctival sutureless pars plana vitrectomy for a variety of vitreoretinal diseases. Methods: A prospective consecutive case series study was performed in 66 eyes of 66 patients. Indications for surgery were epiretinal membrane (n = 20), rhegmatogenous retinal detachment (n = 19: 14 pseudophakic, 5 phakic), macular hole (n = 16), vitreous hemorrhage (n = 5), cyclodialysis (n = 1), intraocular lens luxation (n = 1), asteroid hyalosis (n = 1), congenital retinoschisis (n = 1), and endophtalmitis (n = 2). Main outcome measures included visual acuity, intraocular pressure, and intra-and post-operative complications. Results: Mean patient age at time of operation was 68 +/- 12 years. Overall, visual acuity improved from 1.03 +/- 1.00 logMAR preoperatively to 0.32 +/- 0.33 logMAR postoperatively (p < 0.01) after a mean follow-up time of 9.3 +/- 4.7 months. Mean preoperative intraocular pressure was 13.9 +/- 3.5 mmHg, and mean postoperative intraocular pressure was 17.9 +/- 9.6 mmHg on day 1 (p < 0.01) and 14.7 +/- 2.8 mmHg (p = 0.05) at final visit. Concerning complications, 2 cases of hypotony and 7 of hypertony occurred on day 1, a macular hole reopened some weeks later, and a retinal detachment recurred in one case. Conclusion: 23-gauge transconjunctival sutureless vitrectomy is an effective and safe technique for a variety of vitreoretinal diseases.