Influence of orientation of the external linear incision created by the 25-gauge trocar and related factors on sclerotomy closure: A clinical and optical coherence tomographic study

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dc.contributor.authorMadanagopalan, V, Gen_US
dc.contributor.authorNagesha, C, Ken_US
dc.contributor.authorKhodifad, AMen_US
dc.contributor.authorRaman, Ren_US
dc.date.accessioned2020-04-10T02:01:27Z
dc.date.available2020-04-10T02:01:27Z
dc.date.issued2018-12
dc.description.abstractPurpose: To assess the influence of orientation of the external linear incision created by the trocar and related factors on sclerotomy closure in 25-gauge (25G) transconjunctival vitreous surgery (TVS). Methods: A total of 46 eyes of 46 patients who underwent 25G TVS (23 circumferential incisions and 23 radial incisions) were studied. Clinical and anterior segment optical coherence tomography (AS-OCT)-based comparison of self-sealed and sutured sclerotomies was done. The influence of age, ocular surgeries and injections, axial length, cannula type, sclerotomy quadrant, surgery duration, vitreous base excision, and tamponade on suture rates was analyzed. Results: Of the 46 eyes, 23 eyes required suturing [circumferential: 17 (74%) and radial: 6 (26%); P = 0.003]. A significantly lesser proportion of superonasal quadrant and inferotemporal quadrant sclerotomies needed suturing [9 (24%) and 12 (27%)] when compared with superotemporal quadrant [17 (37%)]. Sclerotomies to the left of the surgeon and the infusion port required significantly lesser suturing [10 (25%) and 13 (28%), respectively] when compared with that of surgeon's right [15 (35%)]. Suturing was significantly lesser when gas or oil tamponade was used [5 (36%) and 2 (20%), respectively] when compared with no tamponade [16 (73%)]. In eyes without tamponade, suturing was lesser with radial sclerotomies (P = 0.003). The odds of having an open sclerotomy tract on AS-OCT were ?5 when circumferential sclerotomies were used. Conclusion: Self-sealing was more common with radial external incisions. Tamponade was associated with less suturing. Superotemporal sclerotomies and sclerotomies toward the surgeon's dominant hand were often sutured. In this cohort, other factors did not influence sclerotomy closure.en_US
dc.identifier.affiliationsVitreoretinal Services, Aravind Eye Hospital, Pondicherry, Tamil Nadu, Indiaen_US
dc.identifier.affiliationsShri Bhagwan Mahavir Vitreoretinal Services, Sankara Nethralaya, Chennai, Tamil Nadu, Indiaen_US
dc.identifier.citationMadanagopalan V G, Nagesha C K, Khodifad AM, Raman R. Influence of orientation of the external linear incision created by the 25-gauge trocar and related factors on sclerotomy closure: A clinical and optical coherence tomographic study. Indian Journal of Ophthalmology. 2018 Dec; 66(12): 1809-1814en_US
dc.identifier.issn0301-4738
dc.identifier.issn1998-3689
dc.identifier.placeIndiaen_US
dc.identifier.urihttps://imsear.searo.who.int/handle/123456789/197010
dc.languageenen_US
dc.publisherAll India Ophthalmological Societyen_US
dc.relation.issuenumber12en_US
dc.relation.volume66en_US
dc.source.urihttps://dx.doi.org/10.4103/ijo.IJO_458_18en_US
dc.subject25-Gauge vitreous surgeryen_US
dc.subjectoptical coherence tomographyen_US
dc.subjectscleral suturingen_US
dc.subjectsclerotomyen_US
dc.titleInfluence of orientation of the external linear incision created by the 25-gauge trocar and related factors on sclerotomy closure: A clinical and optical coherence tomographic studyen_US
dc.typeJournal Articleen_US
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