SELF-SEALING SCLEROTOMIES IN PARS-PLANA V ITRECTOMY

Purpose To study a technique of self-sealing sclerotomies, recently de scribed. Methods After conjunctival peritomy, a tunnel incision is per formed with a crescent knife, 2 mm posterior to the intended site of e ntry. Then a 20G microvitreoretinal blade is used to ender the vitreou s cavity. From November 1996 to April 1997, 99 primary vitrectomies we re prospectively studied. Results 292 sclerotomies were performed with this technique. Self-sealing sclerotomies were observed in 270 cases (92.5%). In 22 cases, leakage of fluid required closure with 8-0 nylon sutures. Leakage was related to multiple instruments used through the sclerotomy, or more frequently to a thin scleral wall. In 1 case, tra nsient hypotony was observed. Ocular pressure spontaneously returned t o normal. Conclusion Self-sealing sclerotomies are difficult to perfor m if the sclera is thin, and leakage can be observed in multiple instr uments have to be used through the same sclerotomy. But this technique prevents vitreous and retinal herniation through the sclerotomy, and ocular hypotony. It also reduces the operative time, and prevents irri tation related to nonabsorbable sutures.