Combined 20 G with 23 G Transconjunctival Vitrectomy For Complicated Vitreoretinal Cases

Purpose: Suturless posterior segment surgery has the advantages of faster wound healing, minimal surgical trauma, and reduced postoperative astigmatism; however, it is still difficult to deal with cases of advanced PVR where peripheral vitreous dissection and silicone oil injection are needed. We combined 23 - gauge and 20 - gauge vitrectomy to improve the outcome of vitreoretinal surgery. Settings: Accurus 800 (Alcon) vitrectomy machine, Alcon disposable 23- G trocar and cannula set, normal 20- G vitrectomy surgical set. Patients and Methods: The study included 20 cases of combined 20 and 23 G pars plana vitrectomies. The indications for surgery included proliferative vitreoretinopathy (PVR) grade C and proliferative diabetic retinopathy (PDR) with tractional retinal detachment. Eyes being injected with silicone oil had 1000 cs silicone oil injected manually through the 20 G port. At the end of the surgery, the single 20 G opening was sutured with 7-0 vicryl. Results: 20 Cases were operated upon, 10 had PVR grade C, and 10 had PDR with tractional retinal detachment. 7 cases with PVR needed single operation while the other 3 cases needed second interference. 8 Cases with PDR with tractional retinal detachment needed single operation and the other 2 cases needed re-interference. Conclusion: Combination of 20-G with 23-G vitrectomy appears to be an efficient technique in dealing with complicated vitreoretinal cases. Besides, being viable from the economical point of view. [Ehab S. El Zakzouk, Mohamed A. Marzouk, Sherif H. Emerah and Ahmed T. Shoer Combined 20 G with 23 G Transconjunctival Vitrectomy For Complicated Vitreoretinal Cases. Life Science Journal. 2011;8(3):304-308] (ISSN:1097-8135). http://www.lifesciencesite.com.