Transconjonctival Sutureless Pars Plana Vitrectomy

Purpose: To evaluate the effectiveness, feasibility and safety of the transconjunctival sutureless vitrectomy (TSV) system for a variety of vitreoretinal procedures. Methods: In this retrospective study, we evaluated 37 eyes of 37 patients who underwent pars plana vitrectomy (PPV) with '25-gauge' TSV system. The indications for surgical intervention were diabetic vitreous hemorrhage (15 eyes), diabetic macular edema (10 eyes), epiretinal membrane (8 eyes), endophthalmitis (3 eyes) and vitreous opacities secondary to Behcet's disease (I eye). Epiretinal membrane and internal limiting membrane removal using '25-gauge' intraocular forceps, endolaser photocoagulation and air-fluid exchange were performed when required. Main outcome measures were intraocular pressure, intraoperative and postoperatiye complications. Results: Preoperative visual acuity was between light perception and 3/10; whereas, postoperative visual acuity was between 3/10 and 8/10. Visual acuity improved in all cases and no major intraoperative complications were observed. No difficulties were encountered while passing through the selerotomies with the instruments, and the required procedures were performed easily. The surgery was completed without conjunctival and scleral suturing in all eyes. Two eyes (%5.4) had relatively low intraocular pressure (8 mmHg) on the first postoperative day; but intraocular pressure was normalized within 1 week without affecting the visual outcome. Three eyes (8.1%) had transient increase of intraocular pressure controlled by topical antiglaucomatous medications. Vitreous hemorrhage recurred in 2 eyes. These eyes underwent vitreous washout using '25-gauge' TSV system, and vitreous hemorrhage did not recur. Conclusion: The TSV system was observed to be feasible, effective and safe in selected cases. This minimally invasive and completely sutureless (transconjunctival) technique appears to decrease the convalescence period, operating time and postoperative inflammatory response, and improve patient comfort.