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Twenty-three gauge cannula system with microvitreoretinal blade trocar
  1. Makoto Inoue1,
  2. Kei Shinoda2,
  3. Akito Hirakata1
  1. 1Kyorin Eye Center, Kyorin University School of Medicine, Tokyo, Japan
  2. 2Department of Ophthalmology, Teikyo University School of Medicine, Tokyo, Japan
  1. Correspondence to Dr Makoto Inoue, Kyorin Eye Center, Kyorin University School of Medicine, 6-20-2 Shinkawa, Mitaka, Tokyo 181-8611, Japan; inoue{at}eye-center.org

Abstract

Aims To report on a 23-gauge cannula with a microvitreoretinal (MVR) blade trocar which improved wound closure after vitrectomy and reduced the incidence of postoperative hypotony.

Methods The resistance of inserting a 23-gauge MVR trocar-cannula through the porcine sclera was compared with that with the conventional 23-gauge trocar-cannula. The incidence of postoperative hypotony (intraocular pressure <6 mm Hg) was determined for 48 eyes that underwent vitrectomy with the 23-gauge MVR trocar-cannula and 30 eyes with the conventional 23-gauge trocar-cannula. The eyes were examined on postoperative days 1, 2 and 7. The closure of the sclerotomies was examined by optical coherence tomography in nine eyes in each group on postoperative days 1, 3 and 7, and 1 month.

Results The resistance of inserting the MVR trocar-cannula was lower than that with the conventional trocar-cannula. In patients, a transient hypotony was found at postoperative day 1 after the vitrectomy in two eyes (4%) with the MVR trocar-cannula, and in seven eyes (23%) with the conventional trocar-cannula (p=0.023). An unclosed incision was detected in nine sclerotomies (50%) with the MVR trocar-cannula and 16 sclerotomies (89%) with the conventional trocar-cannula (p=0.028) on postoperative day 1, and the incidence of an opened incision was also significantly higher with the conventional trocar-cannula on days 3 and 7 but not after 1 month (p=0.003, p=0.008, p=0.486, respectively).

Conclusion The MVR trocar-cannula leads to better postoperative wound closure and reduces the incidence of postoperative hypotony.

  • 23-gauge vitrectomy
  • cannula
  • hypotony
  • postoperative complication
  • surgical instruments
  • retina
  • wound healing

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Footnotes

  • Competing interests None.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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