HEALING OF CONJUNCTIVAL WOUNDS AFTER 23-GAUGE SUTURELESS VITRECTOMY

Abstract

Purpose: To evaluate the healing course of conjunctival wounds in eyes undergoing 23-gauge sutureless vitrectomy and to determine when the potential for ocular surface fluid contamination is no longer a serious concern. Methods: Prospective observational case series. Thirty-four eyes from 34 patients that underwent transconjunctival 23-gauge sutureless vitrectomies were included. A total of 102 conjunctival wounds overlaying the sutureless sclerotomies from 34 eyes were evaluated prospectively by slit-lamp biomicroscopic examination using cobalt blue light with fluorescein dye staining. The configuration and size of the conjunctival wounds were measured with fluorescein dye staining postoperatively on Days 1, 4, 8, and 15. Results: Seventy-five conjunctival wounds (73.5%) had not healed completely 4 days after the operation. Eight days after surgery, the proportion of eyes with fluorescein staining at the conjunctival wound decreased to 13.7%. Fifteen days after surgery, there was no fluorescein staining at the conjunctival wound in any case. Combined cataract extraction was a factor that delayed the healing of the conjunctival wound (P = 0.036). Conclusion: The results suggest that, regarding conjunctival integrity, patients should be safe from intraocular contamination 15 days after 23-gauge sutureless vitrectomy. Concomitant cataract extraction might lengthen the conjunctival wound healing process in these eyes.