Comparison of 20-gauge transconjunctival sutureless vitrectomy with conventional vitrectomy.

PURPOSE: The purpose of the study was 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: Clinical data were reviewed retrospectively for a consecutive series of patients who underwent transconjunctival sutureless vitrectomy (TSV; 38 eyes of 37 patients) and a control group who underwent vitrectomy using the conventional technique (38 eyes of 38 patients). RESULTS: Eighty-nine of 107 sclerotomies (83.2%) in the TSV group self-sealed without the need for sutures. The TSV group showed earlier visual improvement from baseline, as early as 7 postoperative days, compared with 60 days in the conventional group. This was attributed to less surgically induced astigmatism in the TSV group; mean astigmatism at baseline and postoperative days 7, 30, and 90 was -1.05 diopter (D), -2.53 D, -1.32 D, and -1.09 D, respectively, in the TSV group and -1.09 D, -3.91 D (P = 0.0285), -2.57 D (P = 0.0203), and -1.18 D, respectively, 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.