Comparison of 20-Gauge Transconjunctival Sutureless Vitrectomy (TSV) with Conventional Vitrectomy

1. Joo-Eun Lee¹
2. Il-Han Yun²

¹Department of Ophthalmology, Haeundae Paik Hospital, Inje University College of Medicine, Busan, Korea
²Department of Ophthalmology, Pusan Paik Hospital, Inje University College of Medicine, Busan, Korea

Purpose: To compare the efficacy and safety of a transconjunctival sutureless technique for pars plana vitrectomy using conventional 20-gauge instruments versus the conventional technique.

Methods: We retrospectively reviewed the medical records of 38 consecutive patients who underwent vitrectomy or silicone oil removal by 20G TSV and had been followed for at least 6 months after the operation as well as those of 38 additional patients matched for age, sex, and surgical indication who had received conventional 20G vitrectomy.

Results: Eighty-nine (83.2%) of 107 sclerotomies in the TSV group self-sealed without the need for sutures. Both group showed improvement in the median logMAR best corrected visual acuity (BCVA); from 1.70 preoperatively to 1.00 at 90 days postoperatively in the TSV group; 1.50 preoperatively to 0.82 at 90 days postoperatively in the conventional group. However, the TSV group showed earlier visual improvement from the baseline: as early as 7 days postoperatively, compared to 60 days postoperatively in the conventional group. This difference was attributed to less surgically-induced astigmatism in the TSV group. Mean astigmatism at baseline and postoperative days 7, 30, and 90 was -1.05D, -2.53D, -1.32D, and -1.09D in the TSV group and -1.09D, -3.91D (p=0.0285), -2.57D (p=0.0203), and -1.18D in the conventional group. No serious complications were observed in either group, including postoperative hypotony, wound leakage, or endophthalmitis.

Conclusion: The 20-gauge TSV technique is as effective as the conventional technique and offers earlier postoperative recovery.