Short-term safety of 23-gauge single-step transconjunctival vitrectomy surgery.

Purpose: The purpose of this study was to report the safety profile of the Alcon 23-gauge single-step preloaded transconjunctival vitrectomy system.
Methods: This was a retrospective case series examining 118 eyes of 114 patients that underwent 23-gauge vitrectomy between July and November 2007. Patients were observed postoperatively for a minimum of 6 weeks. Main outcome measures were postoperative intraocular pressure (IOP), intraoperative complications, and postoperative adverse events.
Results: The mean postoperative Day 1 IOP was 14.3 +/- 6.6 mmHg (median, 13 mmHg; range, 2-38 mmHg) and Month 1 IOP was 15.8 +/- 5.9 mmHg (median, 15 mmHg; range, 6-52 mmHg). Two eyes (1.7%) developed choroidal effusions. Four eyes (3.4%) developed intraoperative horseshoe tears. No retinal detachments or endophthalmitis occurred. Four eyes (3.4%) had postoperative hypotony. Intraoperative wound leak after cannula removal requiring a sclerotomy suture occurred in 38% of patients: 35 eyes requiring closure of 1 cannula site (29.6%), 8 eyes (6.8%) requiring closure of 2 cannula sites, and 2 eyes (1.7%) requiring closure of all 3 cannula sites.
Conclusion: The Alcon 23-gauge single step preloaded transconjunctival vitrectomy system has few safety issues. Sclerotomy leaks after cannula removal are common, with 38% of eyes requiring suture closure of at least 1 cannula site.