Risk factors associated with sclerotomy leakage and postoperative hypotony after 23-gauge transconjunctival sutureless vitrectomy

Abstract

Purpose: To investigate the incidence and risk factors of sclertomy leakage and postoperative hypotony after 23-gauge transconjunctival sutureless vitrectomy.

Methods: This was a retrospective study including 322 eyes of 292 patients who underwent 23-gauge transconjunctival sutureless vitrectomy by a single surgeon with minimum follow-up period of 1 month. The incidence and risk factors of intraoperative suture placement for leaking sclerotomies and postoperative hypotony (</=5 mmHg) were analyzed in association with seven clinical factors.

Results: Intraoperative suture placement was required for leaking sclerotomies in 36 cases (11.2%) and was related to prior vitrectomy (OR = 7.5), young age (<50 years) at operation (OR = 4.9), and vitreous base dissection (OR = 3.5). The incidences of postoperative hypotony were 11.3% at 2 hours, 6.5% at 5 hours, 3.8% at 1 day, and 0% at 1 week. Myopia and gas tamponade were associated with early postoperative hypotony. No complications developed related to sclerotomy leakage or postoperative hypotony.

Conclusions: The risk factors of intraoperative sclerotomy leakage requiring suture placement after 23-gauge transconjunctival sutureless vitrectomy are prior vitrectomy, a young age at operation, and vitreous base dissection. Caution should be exercised to ensure the detection of sclerotomy leakage and hypotony in cases with these risk factors.