Cryo-compression of sclerotomy sites after transconjunctival sutureless vitrectomy

Abstract

Purpose: Transconjunctival sutureless vitrectomy(TSV) has become more commonly performed, but the incidence of sclerotomy site leakage is becoming an issue. We have developed a new and easy sclerotomy closure technique using cryotherapy, and named it ‘cryo-compression’.
Methods: After the removal of the cannula, sclerotomy sites’ cryotherapy was performed with the setting of one cryospot for each site and ten seconds for each spot. After cryotherapy, firm pressure was maintained for more than 30 seconds. Immediately after compression, when any degree of leakage was detected, a single transconjunctival suture with 8-0 vicryl was placed. Postoperatively, topical steroid and antibiotics eyedrops were administrated.
Results: Sixteen patients undergoing 23-gauge vitrectomy with this technique were reviewed retrospectively. The postoperative one- and six-hour intraocular pressures (IOPs) were significantly lower than preoperative IOP, but postoperative one-day and one-week IOPs were not different from preoperative IOP. Incidence of hypotony was 12.5% (N = 2/16 eyes) at only one hour but all eyes recovered. Intraoperative suture at sclerotomy sites was placed in eight of the 48 sclerotomies(16.7%) and suture placement was not required postoperatively. No cases of severe intraocular inflammation or endophthalmitis were indentified.
Conclusions: Our short-term results are fairly respectable, so we think that the ‘Cryocompression’ technique is helpful to obtain sclerotomy closure in TSV.