Outcome of 20-gauge transconjunctival cannulated sutureless vitrectomy using silicone oil or air tamponade

BACKGROUND: The purpose of this study was to assess the outcome of pars plana vitrectomy using a 20-gauge transconjunctival cannulated sutureless system with air or silicone oil tamponade in cases of retinal detachment of different etiologies. METHODS: A prospective study was performed in 60 eyes from consecutive 60 patients who underwent 20-gauge transconjunctival cannulated sutureless vitrectomy (30 eyes with air tamponade and 30 eyes with silicone oil tamponade), with the inclusion of a further 30 patients who underwent conventional 20-gauge vitrectomy and served as a control group. The main outcome measures were intraocular pressure, wound leakage, and comfort score. RESULTS: Preoperative intraocular pressure increased from 17.67 ± 5.6 mmHg preoperatively to 18.78 ± 6.1 mmHg on the first postoperative day in group A and decreased from 16.97 ± 4.9 mmHg to 15.88 ± 5.3 mmHg in group B. These changes were not statistically significant (P > 0.05). The comfort score ranged from 1 to 5 (1 = very bad, 2 = bad, 3 = good, 4 = very good, and 5 = excellent), with a mean of 4.4 ± 0.94 in group A and 4.35 ± 0.99 in group B on the first postoperative day, and no significant difference in scores between the groups at any follow-up visit. There was intraoperative wound leakage in two cases (6.7%) in group A which required suturing and one case (3.3%) in group B, but the difference was not statistically significant (P > 0.05). There was no wound leakage at follow-up in either group. No cases of hypotony, endophthalmitis, or unsealed sclerotomies were noted. CONCLUSION: Pars plana vitrectomy using a 20-gauge transconjunctival cannulated sutureless system combines the advantages of smaller-gauge vitrectomy systems with the economic advantage of not needing to purchase any additional handheld instruments. It can be used with both air and silicone oil tamponade in most cases of retinal detachment.