A Novel Technique of Suturing Sclerotomy in Pars Plana Vitrectomy

Abstract

Purpose:  To describe a new technique of suturing sclerotomy after 23- gauge pars plana vitrectomy using10 – 0 nylon suture with releasable knot. Study Design:  Quasi experimental study. Place and Duration of Study: Sahiwal Teaching Hospital, Sahiwal, from January 2022 to June 2022. Methods:  10 – 0 nylon sutures with releasable knots were applied to close the sclerotomy after 23 – gauge pars plana vitrectomy in 100 cases. Complications like hypotony and wound leakage were recorded. Intra ocular pressures on 1st post-operative day and after 1 week were monitored. Inflammation at suture site, pain experienced by the patient and surgeon’s convenience of suture removal under a slit lamp after 1 week were documented. Results:  Patients included 58 women and 42 men. Post-operatively, there was no wound leakage and hypotony in any patient, with mean intra ocular pressure of 13.5 ± 2.0 mmHg on 1st post-operative day and 17.6 ± .0.5 mmHg after 1 week of surgery. In 4% cases inflammation was observed at suture site. The mean pain score, measured according to visual analogue scale, at post-operative day 1 and day 7 was 1.25 ± 1.19 and 1.08 ± 0.99 respectively. No discomfort was reported during removal of releasable sutures in 96% of the patients. Surgeon found it convenient to remove the sutures under slit lamp illumination. Conclusion:  Closure of 23 – gauge sclerotomy using nylon 10 – 0 suture with releasable knot is a useful option. It prevents post-operative wound leakage and hypotony.