Introduction:  To evaluate the safety and efficacy of 23-gauge transconjunctival sutureless pars plana vitrectomy for a variety of vitreoretinal diseases.

Objectifs and Methods:  A prospective consecutive case series study was performed in 61 eyes of 61 patients. Indications for surgery were as follows: epiretinal membrane (n=20), rhegmatogenous retinal detachment (n=19: 14 pseudophakic, 5 phakic), macular hole (n=11), vitreous hemorrhage (n=5), cyclodialysis (n=1), intraocular lens luxation (n=1), asteroid hyalosis (n=1), congenital retinoschisis (n=1), and endophtalmitis (n=2). Main outcome measures included visual acuity, intraocular pressure, and intra and postoperative complications.

Results:  Mean patient age at the time of operation was 68.3±12.23 years old. Overall, visual acuity improved from 1.0±1.0 preoperatively to 0.3±0.4 logMAR postoperatively (p<0.01) after a mean follow-up time of 9.6±4.6 months. Visual acuity improved from 0.41±0.18 to 0.27±0.20 logMAR (p<0.01) in patients with epiretinal membrane after a follow-up of 11.5±5.5 months and from 1.36±1.28 to 0.25±0.31 logMAR (p<0.01) in patients with rhegmatogenous retinal detachment after a follow-up of 8.5±3.0 months. Patients with macular holes improved their visual acuity from 0.68±0.29 to 0.59±0.53 (p=0.65) after a follow-up of 8.3±4.0 months. An intraoperative tear was observed in one patient, which required treatment with cryotherapy. Another patient had reopening of the macular hole that closed following second vitrectomy with silicone oil tamponade. In the last group of patients, including various retinal diseases, visual acuity improved from 0.41±0.18 to 0.32±0.28 logMAR (p<0.01) after a follow-up of 9.5±5.4 months. Mean preoperative intraocular pressure was 13.7±3.3mm Hg, and mean postoperative intraocular pressure was 16.8±9.0mm Hg at day 1 (p<0.01) and 14.4±2.7mm Hg at the final visit (p=0.11). Three hypotonies and 6 hypertonies were observed at day 1.

Discussion:  23 gauge transconjunctival sutureless vitrectomy is an effective surgical technique. This technique showed numerous advantages: self-sealing scleral incisions, minimal conjunctival surgical traumatism, decreased operative time, improved patient comfort, and rare complications.

Conclusion:  23 gauge transconjunctival sutureless vitrectomy is an effective and safe technique for a variety of vitreoretinal diseases.