PloS one · 2025
Risk factors for hypotony after transconjunctival sutureless vitrectomy.
СтатьяНаблюдательное исследованиеНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
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Ando Takumi, Terashima Hiroko, Fujii Kazuma, Yoshida Hiromitsu, Ueda Eriko, Nozaki Yohei, Shiozaki Naoya, Yaoeda Kiyoshi, Fukuchi Takeo
Аннотация
PURPOSE: To identify risk factors for unexpected hypotony after transconjunctival sutureless vitrectomy (TSV).
METHODS: In this retrospective observational study, we defined postoperative hypotony as intraocular pressure (IOP) < 6 mmHg on the day after TSV and performed multivariate analysis after dividing patients into hypotony and non-hypotony groups. Peripheral vitrectomy with scleral compression was performed for all patients and completed with normal IOP and no sutures.
RESULTS: Eight-hundred and forty eyes of 748 consecutive patients who underwent 25-G or 27-G TSV were included. Postoperative hypotony occurred in 139 eyes (16.5%) and was associated with longer axial length (AL) (odds ratio [OR], 0.86; P = 0.001) and no tamponade usage (OR, 0.50; P = 0.001). Postoperative complications occurred more frequently in the hypotony group than in the non-hypotony group (51.1% vs. 11.3%, P < 0.001), especially choroidal fold (47.5%) and hypotony maculopathy (2.2%). On dividing patients without tamponade into 3 AL-based groups, the ≥26-mm group had significantly higher hypotony incidence than the 23-26-mm group (33.3% vs. 18.4%; P = 0.024).
CONCLUSION: Longer AL and no tamponade usage influenced hypotony post-TSV. In patients with these factors, especially with AL ≥ 26 mm, surgeons may aggressively consider suturing sclerotomy to minimize hypotony-related complications.
METHODS: In this retrospective observational study, we defined postoperative hypotony as intraocular pressure (IOP) < 6 mmHg on the day after TSV and performed multivariate analysis after dividing patients into hypotony and non-hypotony groups. Peripheral vitrectomy with scleral compression was performed for all patients and completed with normal IOP and no sutures.
RESULTS: Eight-hundred and forty eyes of 748 consecutive patients who underwent 25-G or 27-G TSV were included. Postoperative hypotony occurred in 139 eyes (16.5%) and was associated with longer axial length (AL) (odds ratio [OR], 0.86; P = 0.001) and no tamponade usage (OR, 0.50; P = 0.001). Postoperative complications occurred more frequently in the hypotony group than in the non-hypotony group (51.1% vs. 11.3%, P < 0.001), especially choroidal fold (47.5%) and hypotony maculopathy (2.2%). On dividing patients without tamponade into 3 AL-based groups, the ≥26-mm group had significantly higher hypotony incidence than the 23-26-mm group (33.3% vs. 18.4%; P = 0.024).
CONCLUSION: Longer AL and no tamponade usage influenced hypotony post-TSV. In patients with these factors, especially with AL ≥ 26 mm, surgeons may aggressively consider suturing sclerotomy to minimize hypotony-related complications.