23-Gauge Sutureless Vitrectomy and 20-Gauge Conventional Vitrectomy: A Case Series Comparison of Post Operative Intraocular Pressure

Purpose: To directly compare the post operative intraocular pressure (IOP) after 20- and 23-gauge vitrectomy.Methods: This study is a randomized prospective study that included 60 eyes of 54 patients, these patients were recruited from the outpatient clinic of Kasr Al-Aini University hospital International Eye Hospital. Patients were divided randomly into two groups:Group A: Scheduled for 20-gauge conventional vitrectomy. Group B: Scheduled for 23-gauge sutureless vitrectomy.Results: The mean first day IOP was 19.4 mmHg in the 20-gauge vs 13mmHg in the 23-gauge (p 0.001). Four patients (13%) in the 20-gauge group had a day one IOP above 26 mmHg compared to none in the 23-gauge group. In contrast, three patients (10%) had postoperative hypotony (IOP 10mmHg) in the 23-gauge group compared to one patient in the 20-gauge group. However, at the 1-week follow-up appointment all IOPs less than 10mmHg had returned to within normal limits.Conclusion: Our study indicates less risk of considerably raised IOPs with sutureless 23-gauge system than 20-gauge conventional vitrectomy system. Additional advantages observed included faster wound healing, diminished conjunctivalscarring, improved patient comfort, and decreased post operative inflammation.