Autologous-Fibrin Induction: A Novel Approach for Sutureless Sclerotomy Closure in Pars Plana Vitrectomy

This study presents a novel sutureless closure approach for sclerotomies following pars plana vitrectomy (PPV) and assesses its efficacy and safety. A total of 142 eyes were included in the study. PPV procedures were performed using 23-gauge (23 G) or 25-gauge (25 G) systems. Preoperative characteri...

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Bibliographic Details
Published in:Current eye research 2024-12, Vol.49 (12), p.1308-5
Main Authors: Durmus, Ebubekir, Kunbaz, Ahmad, Kaya, Sabire Pelin, Esen, Fehim, Oguz, Halit, Aykut, Veysel
Format: Article
Language:English
Subjects:
Adult
Aged
Endotamponade
Female
Fibrin Tissue Adhesive - therapeutic use
Follow-Up Studies
Humans
Male
Middle Aged
Retinal Detachment - surgery
Retrospective Studies
Sclera - surgery
Sclerostomy - methods
Suture Techniques
Sutureless Surgical Procedures - methods
Treatment Outcome
Visual Acuity - physiology
Vitrectomy - methods
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Summary:This study presents a novel sutureless closure approach for sclerotomies following pars plana vitrectomy (PPV) and assesses its efficacy and safety. A total of 142 eyes were included in the study. PPV procedures were performed using 23-gauge (23 G) or 25-gauge (25 G) systems. Preoperative characteristics, intraoperative findings, and postoperative outcomes were documented. The cohort included 80 males and 62 females (mean age: 60.4 ± 12 years), primarily undergoing surgery for retinal detachment (59%). Among the patients, 87% underwent 25 G PPV (35% three-port, 52% four-port), while 13% underwent 23 G PPV (12% three-port, 1% four-port). Gas tamponade was administered in all cases, with perfluoropropane used in 45.7% of instances, sulfur hexafluoride in 29.5%, and air in 24.6%. Spontaneous closure was observed in 9.4% (47 of 501) of sclerotomies, autologous-fibrin induction approach successfully closed 75.8% (380 of 501) of the sclerotomies (83.7% of leaking sclerotomies) and 14.7% (74 of 501) of sclerotomies needed sutures. Visual acuity improved postoperatively, and first-day hypotony rate was 6.3%. Importantly, no serious complications such as choroidal detachment or endophthalmitis were observed during the postoperative period. The autologous-fibrin induction offers a simple, cost-efficient, and reliable approach for sutureless sclerotomy closure in PPV, with promising outcomes.
ISSN:0271-3683
1460-2202
1460-2202
DOI:10.1080/02713683.2024.2380441