SUTURELESS CLOSURE OF 23- AND 25-GAUGE LEAKING SCLEROTOMIES WITH THE SCLERAL NEEDLING TECHNIQUE. Issue 5 (May 2020)

• Record Type: Journal Article
• Authors: Felfeli, Tina; Altomare, Filiberto; Mandelcorn, Efrem D.
• Is Part Of: Retina. Volume 40:Issue 5(2020)
• Publication Date: 2020-05
• Subjects: endophthalmitis -- hypotony -- leaking sclerotomy -- microincision vitrectomy surgery -- novel technique -- postoperative intraocular pressure -- sutureless -- transconjunctival sclerotomy -- wound closure; Retina -- Diseases -- Periodicals; Retinal Diseases; Vitreous Body; 617.735
• DOI: 10.1097/IAE.0000000000002484
• Languages: English
• ISSNs: 0275-004X

Abstract

Abstract : Purpose: To describe and evaluate the efficacy of a novel technique, scleral needling (SN), for securing 23- and 25-gauge leaking sclerotomies in microincision vitrectomy surgery. Methods: A retrospective comparative review of consecutive cases of 23- and 25-gauge pars plana vitrectomy performed by a single vitreoretinal surgeon before the introduction of the SN technique (pre-SN; November 2016 to January 2017) and after the introduction of the SN technique (post-SN; November 2017 to January 2018) was conducted. The SN technique was implemented as an alternative to suturing, using a 30-gauge needle inserted perpendicularly through the full thickness of the sclera adjacent to the scleral opening, with the needle then immediately removed and sclerotomy closure confirmed. Results: A total of 203 eyes, 105 from pre-SN and 98 from post-SN, were included in the study. The number of eyes requiring suture closure was significantly reduced from 39% in the pre-SN group to 2% in the post-SN group ( P < 0.001). The mean postoperative intraocular pressure and incidence of hypotony on Days 1 to 2, Days 3 to 20, and Days 21 to 50 was not significantly different between the pre-SN and post-SN groups. No major complications associated with the SN technique were noted during the study period. Conclusion: The SN technique is a safe and simple method for effectively securing leaking sclerotomies in microincision vitrectomy surgery. Abstract : Supplemental Digital Content is Available in the Text.A retrospective comparative review illustrates the efficacy of sutureless closure of 23- and 25-gauge sclerotomies with the scleral needling technique, which uses a 30-gauge needle insertion adjacent to the scleral opening and immediate removal from the bed of the scleral tunnel for securing leaking wounds.