Self-sealing, sutureless sclerotomy in pars-plana vitrectomy

Background If sutures are used in the regular closure of sclerotomies a tra uma to the bulbus can be inflicted and intraocular bleeding might result. P hases of intraocular hypotony accompany the intraoperative exchange of inst ruments. Like in no-stitch cataract surgery we employed this type of self-s ealing wound closure in pars-plana vitrectomies. A less traumatizing techni que yielding a tight and effective closure is an alternative to the convent ional approach and results of our experiences are presented. Materials and methods A modified approach for sutureless sclerotomy closure was applied in 50 eyes (150 sclerotomies). A sclera-covered sclerotomy is performed after preparation of adequate scleral pouches in conventional pos itions. A minimal conjunctival peritomy allows at the end of surgery an ele ctric cauterization, thus using no suture material in the whole course of v itrectomy. Results Sutureless vitrectomies can only be installed in the primary operat ion. However, re-operations on 3 eyes were possible in the same manner usin g the old sclerotomy sites up to 6 weeks after initial surgery. In 12 eyes the sclerotomy had to be covered with a single suture to obtain adequate wo und closure. A repetitive change of instruments during the surgical procedu re is possible with this technique and all types of intraocular instruments can be employed. Conclusions Self-sealing sclerotomies are a simple and atraumatic approach for wound closure in pars-plana vitrectomies and allow a control of intraoc ular pressure during surgery.