25-gauge scleral tunnel transconjunctival vitrectomy

Abstract

Purpose: To compare the intraocular fluid leakage rate between 25-gauge (25G) transconjunctival vitrectomy with scleral tunnels and standard 25G transconjunctival vitrectomy.

Design: Single-center, retrospective, interventional case series.

Methods: Transconjunctival vitrectomies were conducted by the use of only 25G instruments with peripheral vitrectomy. Standard 25G vitrectomy was conducted in 542 eyes and 25G vitrectomy with scleral tunnels in 337 eyes. The scleral tunnel was created by inserting trocars at an oblique angle.

Results: The intraocular fluid leakage rate was significantly lower (Fisher exact probability test: P < .0001) when scleral tunnels were used in 25G vitrectomy (1%, five of 337 eyes) compared with standard 25G vitrectomy (9%, 50 of 542 eyes). The wound leakage rate was significantly lower when using (rather than not) scleral tunnels in 25G vitrectomy, both without air-gas (P = .0258) and with air exchange (P = .0007).

Conclusion: The use of scleral tunnels in 25G transconjunctival vitrectomy reduces the frequency of wound leakage even when the peripheral vitreous is removed.