Comparative Analysis of Sutured and Sutureless 25G Pars Plana Vitrectomy: Impact on Surgically Induced Astigmatism and Hypotony
Introduction: Vitreoretinal surgery has advanced with transconjunctival sutureless vitrectomy (TSV), using smaller incisions. However, TSV often causes hypotony due to sclerotomy leakage, leading to severe postoperative issues. This study compares outcomes between sutureless and sutured 25G pars pla...
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Galenos Yayinevi
2025-08-01
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| Series: | İstanbul Medical Journal |
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| Online Access: | https://www.istanbulmedicaljournal.org/articles/comparative-analysis-of-sutured-and-sutureless-25g-pars-plana-vitrectomy-impact-on-surgically-induced-astigmatism-and-hypotony/doi/imj.galenos.2025.92844 |
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| author | Ebubekir Durmuş Ahmad Kunbaz Gözde Derin Şengün Veysel Aykut Fehim Esen Halit Oğuz |
| author_facet | Ebubekir Durmuş Ahmad Kunbaz Gözde Derin Şengün Veysel Aykut Fehim Esen Halit Oğuz |
| author_sort | Ebubekir Durmuş |
| collection | DOAJ |
| description | Introduction: Vitreoretinal surgery has advanced with transconjunctival sutureless vitrectomy (TSV), using smaller incisions. However, TSV often causes hypotony due to sclerotomy leakage, leading to severe postoperative issues. This study compares outcomes between sutureless and sutured 25G pars plana vitrectomy (PPV) and highlights sutures’ significance in TSV.
Methods: Fifty-four eyes underwent 25G PPV, divided into sutureless and sutured groups based on sclerotomy closure methods. Preoperative and postoperative evaluations at 1 week, 1 month, and 3 months included corrected distance visual acuity (CDVA), intraocular pressure (IOP), auto refractometer readings, and corneal topography. Special attention was given to postoperative hypotony, and surgically induced astigmatism (SIA) was assessed.
Results: The sutureless (mean age: 67.4±9.1 years, n=31) and sutured (mean age: 59.2±12.7 years, n=23) groups were analyzed. The sutureless group showed stable SIA at 1 and 3 months (1.39±1.1 vs. 1.30±0.9, p=0.695). The sutured group had higher SIA at 1 month (3.16±3.2 vs. 1.39±1.1, p=0.009), which decreased by 3 months (3.16±3.2 vs. 1.95±1.4, p=0.021). No significant intergroup differences were observed at the third month postoperatively. CDVA improved significantly in both groups (p<0.001), highlighting surgical efficacy. IOP was comparable to that of the sutureless group, but transient hypotony occurred in the sutureless group. IOP consistency favored the sutured group.
Conclusion: The study findings underscore the impact of suturing the sclerotomy ports on elevating SIA. However, it's crucial to note that SIA usually decreases by the third postoperative month, whereas hypotony-related complications can have enduring effects. Surgeons must carefully assess hypotony risks, particularly in children or in cases of high myopia, deciding on the necessity of sutures in microincisional PPV. |
| format | Article |
| id | doaj-art-9ac0a0e2953b40738d2f032b7a701fb7 |
| institution | Kabale University |
| issn | 2619-9793 2148-094X |
| language | English |
| publishDate | 2025-08-01 |
| publisher | Galenos Yayinevi |
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| series | İstanbul Medical Journal |
| spelling | doaj-art-9ac0a0e2953b40738d2f032b7a701fb72025-08-20T03:40:37ZengGalenos Yayineviİstanbul Medical Journal2619-97932148-094X2025-08-0126319119610.4274/imj.galenos.2025.92844Comparative Analysis of Sutured and Sutureless 25G Pars Plana Vitrectomy: Impact on Surgically Induced Astigmatism and HypotonyEbubekir Durmuş0https://orcid.org/0000-0003-3242-2665Ahmad Kunbaz1https://orcid.org/0000-0003-2209-8187Gözde Derin Şengün2https://orcid.org/0000-0002-2748-3079Veysel Aykut3https://orcid.org/0000-0003-0658-0897Fehim Esen4https://orcid.org/0000-0002-9948-5575Halit Oğuz5https://orcid.org/0000-0002-0983-5878İstanbul Medeniyet University Faculty of Medicine Department of Ophthalmology, İstanbul, Türkiyeİstanbul Medeniyet University Faculty of Medicine Department of Ophthalmology, İstanbul, Türkiyeİstanbul Medeniyet University Faculty of Medicine Department of Ophthalmology, İstanbul, Türkiyeİstanbul Medeniyet University Faculty of Medicine Department of Ophthalmology, İstanbul, Türkiyeİstanbul Medeniyet University Faculty of Medicine Department of Ophthalmology, İstanbul, Türkiyeİstanbul Medeniyet University Faculty of Medicine Department of Ophthalmology, İstanbul, TürkiyeIntroduction: Vitreoretinal surgery has advanced with transconjunctival sutureless vitrectomy (TSV), using smaller incisions. However, TSV often causes hypotony due to sclerotomy leakage, leading to severe postoperative issues. This study compares outcomes between sutureless and sutured 25G pars plana vitrectomy (PPV) and highlights sutures’ significance in TSV. Methods: Fifty-four eyes underwent 25G PPV, divided into sutureless and sutured groups based on sclerotomy closure methods. Preoperative and postoperative evaluations at 1 week, 1 month, and 3 months included corrected distance visual acuity (CDVA), intraocular pressure (IOP), auto refractometer readings, and corneal topography. Special attention was given to postoperative hypotony, and surgically induced astigmatism (SIA) was assessed. Results: The sutureless (mean age: 67.4±9.1 years, n=31) and sutured (mean age: 59.2±12.7 years, n=23) groups were analyzed. The sutureless group showed stable SIA at 1 and 3 months (1.39±1.1 vs. 1.30±0.9, p=0.695). The sutured group had higher SIA at 1 month (3.16±3.2 vs. 1.39±1.1, p=0.009), which decreased by 3 months (3.16±3.2 vs. 1.95±1.4, p=0.021). No significant intergroup differences were observed at the third month postoperatively. CDVA improved significantly in both groups (p<0.001), highlighting surgical efficacy. IOP was comparable to that of the sutureless group, but transient hypotony occurred in the sutureless group. IOP consistency favored the sutured group. Conclusion: The study findings underscore the impact of suturing the sclerotomy ports on elevating SIA. However, it's crucial to note that SIA usually decreases by the third postoperative month, whereas hypotony-related complications can have enduring effects. Surgeons must carefully assess hypotony risks, particularly in children or in cases of high myopia, deciding on the necessity of sutures in microincisional PPV.https://www.istanbulmedicaljournal.org/articles/comparative-analysis-of-sutured-and-sutureless-25g-pars-plana-vitrectomy-impact-on-surgically-induced-astigmatism-and-hypotony/doi/imj.galenos.2025.9284425-gauge pars plana vitrectomytransconjunctival sutureless vitrectomysurgically induced astigmatismhypotony |
| spellingShingle | Ebubekir Durmuş Ahmad Kunbaz Gözde Derin Şengün Veysel Aykut Fehim Esen Halit Oğuz Comparative Analysis of Sutured and Sutureless 25G Pars Plana Vitrectomy: Impact on Surgically Induced Astigmatism and Hypotony İstanbul Medical Journal 25-gauge pars plana vitrectomy transconjunctival sutureless vitrectomy surgically induced astigmatism hypotony |
| title | Comparative Analysis of Sutured and Sutureless 25G Pars Plana Vitrectomy: Impact on Surgically Induced Astigmatism and Hypotony |
| title_full | Comparative Analysis of Sutured and Sutureless 25G Pars Plana Vitrectomy: Impact on Surgically Induced Astigmatism and Hypotony |
| title_fullStr | Comparative Analysis of Sutured and Sutureless 25G Pars Plana Vitrectomy: Impact on Surgically Induced Astigmatism and Hypotony |
| title_full_unstemmed | Comparative Analysis of Sutured and Sutureless 25G Pars Plana Vitrectomy: Impact on Surgically Induced Astigmatism and Hypotony |
| title_short | Comparative Analysis of Sutured and Sutureless 25G Pars Plana Vitrectomy: Impact on Surgically Induced Astigmatism and Hypotony |
| title_sort | comparative analysis of sutured and sutureless 25g pars plana vitrectomy impact on surgically induced astigmatism and hypotony |
| topic | 25-gauge pars plana vitrectomy transconjunctival sutureless vitrectomy surgically induced astigmatism hypotony |
| url | https://www.istanbulmedicaljournal.org/articles/comparative-analysis-of-sutured-and-sutureless-25g-pars-plana-vitrectomy-impact-on-surgically-induced-astigmatism-and-hypotony/doi/imj.galenos.2025.92844 |
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