Diathermy for 23-gauge sclerotomy: a functional and morphologic study to avoid ocular hypotony

Soraya Horowitz1, Nadyr A Damasceno1, Felipe Muralha2, Maurício B Pereira3, Mauricio Maia2, Eduardo F Damasceno3 1Department of Ophthalmology, Hospital Naval Marcilio Dias, Rio de Janeiro, Brazil; 2Department of Ophthalmology, The Universidade Federal de São Paulo, Brazil; 3Dep...

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Autores principales:	Horowitz S, Damasceno NA, Muralha F, Pereira MB, Maia M, Damasceno EF
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2019
Materias:	Vitreoretinal Surgery Pars Plana Vitrectomy 23-gauge Sclerotomy Conjunctival and Scleral Diathermy Vitrectomy complications Ophthalmology RE1-994
Acceso en línea:	https://doaj.org/article/90fe36e775fa4f79a8b049dcd20d6936
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spelling	oai:doaj.org-article:90fe36e775fa4f79a8b049dcd20d69362021-12-02T01:54:19ZDiathermy for 23-gauge sclerotomy: a functional and morphologic study to avoid ocular hypotony1177-5483https://doaj.org/article/90fe36e775fa4f79a8b049dcd20d69362019-09-01T00:00:00Zhttps://www.dovepress.com/diathermy-for-23-gauge-sclerotomy-a-functional-and-morphologic-study-t-peer-reviewed-article-OPTHhttps://doaj.org/toc/1177-5483Soraya Horowitz1, Nadyr A Damasceno1, Felipe Muralha2, Maurício B Pereira3, Mauricio Maia2, Eduardo F Damasceno3 1Department of Ophthalmology, Hospital Naval Marcilio Dias, Rio de Janeiro, Brazil; 2Department of Ophthalmology, The Universidade Federal de São Paulo, Brazil; 3Department of Ophthalmology, Universidade Federal Fluminense, Niterói, BrazilCorrespondence: Eduardo F DamascenoMarques do Paraná, 303 Niteroi, 20530050 BrazilTel +55 212 562 2343Email e_damasceno@yahoo.comPurpose: To evaluate diathermy to minimize sclerotomy leakage during small-gauge vitrectomy and prevent ocular hypotony.Methods: This observational prospective study included 327 patients (327 eyes) who underwent diathermy to close the sclerotomy sites during 23-gauge pars plana vitrectomy (PPV). All patients were operated by a single surgeon (ED) and evaluated at 30 and 60 days postoperatively. Patients with glaucoma, topical/systemic steroids use exceeding 30 days, ocular inflammation, or trauma were excluded. Chi-square, Kruskal–Wallis, Fisher Exact test, and multivariate statistical analyses were performed to evaluate potential risk factors. The primary outcomes were open sclerotomies, leakage, and ocular hypotony.Results: Sclerotomies remained open in 12 (3.6%) and 2 (0.6%) patients, respectively, at 30 and 60 days postoperatively, revealing no case of ocular hypotony. Leakage only occurred in four patients (1.2%) during week 1 postoperatively. Multivariate analysis indicated that additional vitreoretinal surgeries and longer surgeries were risk factors for persistent sclerotomy opening.Conclusion: Diathermy was safe and feasible to close sclerotomies. Vitreoretinal surgery reoperations and longer surgeries were the most significant (P<0.05) risk factors for persistent sclerotomy opening, which may be functionally closed without evidence of leakage or ocular hypotony.Keywords: vitreoretinal surgery, pars plana vitrectomy, 23-gauge sclerotomy, sclerotomy closure, sclerotomy diathermy, vitrectomy complicationsHorowitz SDamasceno NAMuralha FPereira MBMaia MDamasceno EFDove Medical PressarticleVitreoretinal SurgeryPars Plana Vitrectomy23-gauge SclerotomyConjunctival and Scleral DiathermyVitrectomy complicationsOphthalmologyRE1-994ENClinical Ophthalmology, Vol Volume 13, Pp 1703-1710 (2019)
institution	DOAJ
collection	DOAJ
language	EN
topic	Vitreoretinal Surgery Pars Plana Vitrectomy 23-gauge Sclerotomy Conjunctival and Scleral Diathermy Vitrectomy complications Ophthalmology RE1-994
spellingShingle	Vitreoretinal Surgery Pars Plana Vitrectomy 23-gauge Sclerotomy Conjunctival and Scleral Diathermy Vitrectomy complications Ophthalmology RE1-994 Horowitz S Damasceno NA Muralha F Pereira MB Maia M Damasceno EF Diathermy for 23-gauge sclerotomy: a functional and morphologic study to avoid ocular hypotony
description	Soraya Horowitz1, Nadyr A Damasceno1, Felipe Muralha2, Maurício B Pereira3, Mauricio Maia2, Eduardo F Damasceno3 1Department of Ophthalmology, Hospital Naval Marcilio Dias, Rio de Janeiro, Brazil; 2Department of Ophthalmology, The Universidade Federal de São Paulo, Brazil; 3Department of Ophthalmology, Universidade Federal Fluminense, Niterói, BrazilCorrespondence: Eduardo F DamascenoMarques do Paraná, 303 Niteroi, 20530050 BrazilTel +55 212 562 2343Email e_damasceno@yahoo.comPurpose: To evaluate diathermy to minimize sclerotomy leakage during small-gauge vitrectomy and prevent ocular hypotony.Methods: This observational prospective study included 327 patients (327 eyes) who underwent diathermy to close the sclerotomy sites during 23-gauge pars plana vitrectomy (PPV). All patients were operated by a single surgeon (ED) and evaluated at 30 and 60 days postoperatively. Patients with glaucoma, topical/systemic steroids use exceeding 30 days, ocular inflammation, or trauma were excluded. Chi-square, Kruskal–Wallis, Fisher Exact test, and multivariate statistical analyses were performed to evaluate potential risk factors. The primary outcomes were open sclerotomies, leakage, and ocular hypotony.Results: Sclerotomies remained open in 12 (3.6%) and 2 (0.6%) patients, respectively, at 30 and 60 days postoperatively, revealing no case of ocular hypotony. Leakage only occurred in four patients (1.2%) during week 1 postoperatively. Multivariate analysis indicated that additional vitreoretinal surgeries and longer surgeries were risk factors for persistent sclerotomy opening.Conclusion: Diathermy was safe and feasible to close sclerotomies. Vitreoretinal surgery reoperations and longer surgeries were the most significant (P<0.05) risk factors for persistent sclerotomy opening, which may be functionally closed without evidence of leakage or ocular hypotony.Keywords: vitreoretinal surgery, pars plana vitrectomy, 23-gauge sclerotomy, sclerotomy closure, sclerotomy diathermy, vitrectomy complications
format	article
author	Horowitz S Damasceno NA Muralha F Pereira MB Maia M Damasceno EF
author_facet	Horowitz S Damasceno NA Muralha F Pereira MB Maia M Damasceno EF
author_sort	Horowitz S
title	Diathermy for 23-gauge sclerotomy: a functional and morphologic study to avoid ocular hypotony
title_short	Diathermy for 23-gauge sclerotomy: a functional and morphologic study to avoid ocular hypotony
title_full	Diathermy for 23-gauge sclerotomy: a functional and morphologic study to avoid ocular hypotony
title_fullStr	Diathermy for 23-gauge sclerotomy: a functional and morphologic study to avoid ocular hypotony
title_full_unstemmed	Diathermy for 23-gauge sclerotomy: a functional and morphologic study to avoid ocular hypotony
title_sort	diathermy for 23-gauge sclerotomy: a functional and morphologic study to avoid ocular hypotony
publisher	Dove Medical Press
publishDate	2019
url	https://doaj.org/article/90fe36e775fa4f79a8b049dcd20d6936
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_version_	1718402855164968960

Diathermy for 23-gauge sclerotomy: a functional and morphologic study to avoid ocular hypotony

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