Minimal fluid-air exchange in combined 23-gauge sutureless vitrectomy, phacoemulsification, and intraocular lens implantation.

PURPOSE: The purpose of this study was to compare rates of postoperative hypotony and intraocular lens-related complications between minimal fluid-air exchange and partial fluid-air exchange in combined 23-gauge vitrectomy and cataract surgery.

METHODS

A prospective, consecutive, interventional case series of 48 eyes that underwent 23-gauge vitrectomy with a minimal fluid-air exchange (minimal F-A group) was compared with a retrospective, consecutive case series of 38 eyes that underwent 23-gauge vitrectomy with a partial fluid-air exchange (partial F-A group). The main outcome measures were postoperative hypotony (<6 mmHg) and intraocular lens-related complications, such as posterior capsule opacification or pupillary capture.

RESULTS

Two (5.3%) of 38 eyes in the partial F-A group had hypotony, and only 1 (2.1%) of 48 eyes in the minimal F-A group had hypotony (P > 0.05). Posterior capsule opacification was identified in 11 (28.9%) of 38 eyes in the partial F-A group but only in 4 (8.3%) of 48 eyes in the minimal F-A group (P = 0.013). Pupillary capture was observed in 3 (7.9%) of 38 eyes in the partial F-A group, but it was absent in the minimal F-A group (P = 0.049). No retinal detachment or endophthalmitis was developed in both groups during follow-up.

CONCLUSION

Minimal fluid-air exchange in combined 23-gauge sutureless vitrectomy and cataract surgery may reduce postoperative hypotony and intraocular lens-related complications.