الفهرس 
Milestones of pars plana vitrectomyOnly 14 pages are availabe for public view
 |  | from | 111 |  |  |
| | | from | 111 | | |
Abstract
-68- Summary Summary This series is a prospective study carried out from August 2009 to August 2011 on 70 eyes of 65 patients divided randomly into 2groups: group 1 included 34 eyes operated using 20 gauge Claes system and group 2 included 36 eyes operated using conventional 20 gauge system.
There was highly significant statistical difference between preoperative and postoperative visual acuity in group 1 (P=0.0001) and group 2 (P=0.002).
There was no statistical difference between group 1 and 2 regarding preoperative visual acuity (P 0.05) and postoperative visual acuity (P 0.05).
The vision was improved in 29 cases (85.3%) in group 1 and 26 cases (72.2%) in group 2.The vision remained unchanged in 3 cases(8.8%) in group 1and 2 cases (5.5%) in group 2. Vision was worsened in 2 cases (5.9%) in group 1 and 8 cases (22.2) in group 2.
There was statistical difference (P=0.016) between group 1 versus 2 in the preoperative IOP. There was no statistical difference between the two groups regarding one day post-operative (P=0.408) and one week postoperative IOP (P=0.594). When comparing the pre-operative (I), one day post-operative(II) and one week postoperative IOP(III) in the same group, there was no statistical difference in group 1 (P=0.234) but there was high statistical difference in group 2 (P=0.0001) between preoperative and one day postoperative IOP (P=0.003) and between preoperative and one week postoperative IOP (P=0.003).
There was statistical difference between the two groups regarding cases of silicone oil tamponade (P=0.041).
-69-Summary There was statistical difference between the intraocular pressure(IOP) one day postoperative regarding cases of silicone oil tamponade between the two groups.
Regarding additional procedures done with vitrectomy, cataract extraction was done for preexisting cataract in 6 cases in group 1 (one case by phacoemulsification and 5 cases by endofragmentation) and 8 cases in group 2 (all by endofragmentation).
Regarding the type of tamponade used, silicone oil was used in 21 cases (61.8%) in group 1 and 28 cases (77.8%) in group 2. Gas tamponade was used in one case in group 1 (2.9%) and 8 cases (77.8%) in group 2 (macular hole cases). Air tamponade was used in 11 cases (32.2%) in group 1(vitreous hemorrhage cases) and not used in group 2.
Fluid tamponade was used in one case in group 1(the case of posterior dislocated lens) and not used in group 2.
Regarding the number of sutures taken, in group 1, 68 sclerotomies (out of 102) were not sutured (66.6%) while the remaining 34 sclerotomies (33.4%) were sutured with single transconjunctival or transscleral suture. The reasons for suturing included leakage of air, gas or silicone oil. In group 2, all sclerotomies were sutured.
Regarding the intra-operative complications of the studied groups, there was highly statistical difference (P= 0.018) between presence and absence of complications among groups. Non-entry site iatrogenic retinal tears occurred in 10 out of 11 (90.9%) of the complicated cases and 29.4% out of total (34) cases in group 1 and 2 out of 3 (66.7%) of the complicated cases and 5.5% out of total (36) cases in group 2. Leakage of gas around the infusion cannula occurred in only one case in group 1 (9.1% of complicated cases and 2.9% of total cases).
Suprachoroidal hematoma occurred in only one case in group 2 (33.3 %-70- Summary of complicated cases and 2.8 % of total cases) and does not occur in other groups.
Regarding the postoperative complications of the studied groups, there was highly statistical difference (P= 0.007) between presence and absence of complications among groups. Cataract occurred in 9 out of 24 cases (37.5%) in group 1 and 10 out of 24 cases (41.6 %) in group 2. In all cases, no cataract extraction needed during follow up.
Persistent high IOP despite of maximal medical treatment occurred only in 2 out of 27 (7.4%) of complicated cases and 5.9% out of total cases of group 1 and did not occur in group 2. Rubeosis occurred only in 1 out of 27 (3.7%) of complicated cases and 2.9% out of total cases of group 1 and did not occur in group 2. Re VH occurred in 2 out of 27 (7.4%) of the complicated cases and 18.2% out of VH cases (11) in group 1 and did not occur in group 2. Premacular hemorrhage occurred in 3 out of 27 11.1%) of the complicated cases and 8.8% out of total (34) cases in group 1 and 1 out of 20 (5 %) of the complicated cases and 2.8 % out of total (36) cases in group 2. Corneal ulcer and dellen occurred in 2 out of 27 (7.4%) of the complicated cases and 5.9% out of total (34) cases in group 1 and 3 out of 20 (15 %) of the complicated cases and 8.3 % out of total (36) cases in group 2. Hyphema occurred only in 1 out of 27 (3.7%) of complicated cases and 2.9% out of total cases of group 1 and in 1 out of 20 (5%) of complicated cases and 2.8% out of total cases of group 2.
Hypotony (defined as IOP less than or equal to 6 mmHg) occurred in 1 out of 27 (3.7%) of the complicated cases and 2.9% out of total (34) cases in group 1and in no cases in group 2. In this case of hypotony, IOP was normalized within 2-4 days postoperative, no choroidal detachment occurred, no supplemental tamponade was needed and it had no effect on the visual outcome. Endophthalmitis occurred only in 1 out of 20 (5%)-71-Summary of complicated cases and 2.8% out of total cases of group 2. AC reaction and inflammatory membrane occurred in 2 cases out of 27 (7.4%) of complicated cases and 5.9% out of total cases of group 1and did not occur in group 2. Cystoid macular edema (CME) occurred only in 1 out of 27(3.7%) of complicated cases and 2.9% out of total cases of group 1.
Failure of macular hole (MH) closure occurred in 1 out of 27 (3.7%) of the complicated cases and 100% out of MH cases (1 case) in group 1 and 1 out of 20 (5 %) of the complicated cases and 12.5% out of MH cases (8 cases) in group 2. Silicone oil in the AC occurred only in 1 out of 27(3.7%) of complicated cases and 2.9% out of total cases of group 1.
Scleral staphylomatous areas at the site of previous sclerotomies occurred in one case in group 1(2.9%) and 3 cases (8.3%) in group 2.