Incidence of rebleed following 23 gauge transconjunctival sutureless vitrectomy for vitreous hemorrhage due to vascular etiologies

Abstract

Context: There has been speculation among surgeons on whether the incidence of rebleeds is higher whilst using the small gauge surgery and the concern is probably due to the higher reported incidence of post-operative hypotony in sutureless wounds. Hence, we carried out this study to report the incidence of rebleed following 23 gauge transconjunctival sutureless vitrectomy (TSV) for vitreous hemorrhage (VH) due to vascular etiologies. Aims: The aim of our study was to study the incidence of rebleed following 23 gauge TSV for VH due to vascular etiologies. Settings and Design: Retrospective case series. Materials and Methods: One hundred and nineteen eyes underwent 23-gauge TSV for VH due to proliferative diabetic retinopathy (n = 95), retinal vein occlusion (n = 15) and vasculitis (n = 9). Patients were examined post-operatively on day 1, 30, 90, and finally at 180 days. Statistical Analysis Used: Paired t-test and Fisher test. Results: Rebleed was noted in 17 patients of whom 3 had spontaneous clearance while 14 (11.8%) had a non-clearing post-operative vitreous hemorrhage. Of these 14 eyes, re-vitrectomy was performed in 8 eyes while six patients underwent air blood exchange. Conclusions: The incidence of non-clearing VH requiring intervention following 23 gauge TSV is 11.8%. All the eyes had clear media at final follow-up.

Keywords

• 23 gauge vitrectomy
• rebleed
• sutureless vitrectomy
• vitreous hemorrhage