July 07, 2014
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Sclerotomy maintenance with 20-gauge cannula may prevent postoperative hypotony, need for suture

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Use of a 20-gauge valved cannula to maintain self-sealing sclerotomy wounds after pars plana phacofragmentation instead of a 23-gauge cannula can help prevent postoperative hypotony; however, fragmatome tip fracture can occur, according to study findings.

The retrospective study included 45 eyes of 44 patients. Among these patients, researchers compared suture rates for two groups: 31 eyes of 31 patients who underwent 23-gauge phacofragmentation where the 23-gauge fragmatome was inserted at the sclerotomy site without a cannula, and 14 eyes of 13 patients who underwent 23-gauge phacofragmentation where the 23-gauge cannula was temporarily replaced with a 20-gauge valved metal cannula. All patients had at least 2 weeks of follow-up.

Sclerotomy suturing was necessary in all of the eyes in the without-cannula group, whereas only one eye in the 20-gauge group required suture. Hypotony was found in five eyes in the without-cannula group but in none of the eyes in the with-cannula group, according to the researchers.

One case of choroidal detachment was reported in the eyes with hypotony in the without-cannula group. There was no significant change in IOP postoperatively between the two groups during follow-up visits, the researchers found.

Disclosure: The authors have no relevant financial disclosures.