Postoperative Complications Associated With 25-Gauge Pars Plana Vitrectomy

Abstract

<H4>BACKGROUND AND OBJECTIVE</H4> <P>To report postoperative complications in eyes undergoing 25-gauge pars plana vitrectomy (PPV).</P> <H4>PATIENTS AND METHODS</H4> <P>Seventy consecutive eyes that underwent 25-gauge PPV for various indications, including epiretinal membrane, non-clearing vitreous hemorrhage, and idiopathic macular hole, and had a minimum follow-up of 12 weeks were reviewed retrospectively. Main outcome measures included bestcorrected Snellen visual acuity, intraocular pressure (IOP), intraoperative complications, and postoperative complications.</P> <H4>RESULTS</H4> <P>The mean visual acuity improved from 20/368 preoperatively to 20/105 postoperatively (<I>P</I> <.00005). Intraoperative complications included retinal tears in 2 eyes (2.9%). Postoperative complications included cataract progression in 17 eyes (42.5%), cystoid macular edema exacerbation in 5 eyes (7.1%), and retinal detachment in 1 eye (1.4%). Postoperative day 1 IOP was statistically lower than preoperative IOP in fluid-filled eyes (<I>P</I> = .031) but not in eyes filled with intravitreal air (<I>P</I> = .30) or gas (<I>P</I> = .52). Sclerotomy sutures were required intraoperatively in 5 eyes (7.1 %) and postoperative day 1 hypotony was noted in 4 eyes (5.7%). All of these complications were noted in fluid-filled eyes except for one case of postoperative day 1 hypotony with gas tamponade.</P> <H4>CONCLUSIONS</H4> <P>Intraoperative and postoperative complications were rare in this series of 25-gauge PPV. Postoperative cataract progression and hypotony were the most common complications. Fluid-filled eyes appear to have a higher risk of wound leakage and postoperative hypotony after 25-gauge PPV than eyes with air or gas tamponade.</P> <P>[<CITE>Ophthalmic Surg Lasers Imaging</CITE> 2007;38:270- 275.]</P> <H4>AUTHORS</H4> <P>From the Retina Service (OPG, CDR, MSF, RSK, ACH, JAM, JFV), Wills Eye at Thomas Jefferson University, Philadelphia, Pennsylvania; and the Department of Ophthalmology (EDW), Walter Reed Army Medical Center, Washington, DC.</P> <P>Accepted for publication April 20, 2007.</P> <P>Funded in part by the Eye Research Institute and Wills Eye Retina Service, Philadelphia, Pennsylvania.</P> <P>Presented in part at the Annual Retina Society Meeting, Del Coronado, California, September 14-18, 2005, and the Association for Research in Vision and Ophthalmology, Annual Meeting, Ft. Lauderdale, Florida, April 30-May 4, 2006.</P> <P>Address correspondence to Carl D. Regillo, MD, Wills Eye Institute, 840 Walnut Street, Suite 1020, Philadelphia, PA 19107.</P>