Factors affecting wound leakage in 23-gauge sutureless pars plana vitrectomy

Albert L. Lin, Deepta A. Ghate, Zachary M. Robertson, Patrick Sean O'Sullivan, Warren L. May, Ching Jygh Chen

Research output: Contribution to journalArticle

28 Citations (Scopus)

Abstract

Purpose: To evaluate risk factors for sclerotomy leakage in 23-gauge sutureless pars plana vitrectomy in 219 patients. Methods: Nested case-control study involving 48 patients with wound leaks (visible on-table sclerotomy leakage requiring sutures) and 171 control subjects without wound leaks. Patients received either a conventional sclerotomy incision at 45°, which was then changed to 90° midincision, or an extremely oblique sclerotomy incision (OSI) at 10°, which was then changed to 30° midincision. Risk factors studied included age, gender, laterality, surgical duration, sclerotomy incision (OSI vs. conventional sclerotomy incision), preoperative diagnosis (macular vs. nonmacular), history of vitrectomy, and primary surgeon (attending vs. supervised resident). Results: Multivariate logistic regression analysis found significant (P ≤ 0.05) protective factors for wound leakage including OSI, macular preoperative diagnosis, no previous vitrectomy, and female gender. Surgical duration at least 45 minutes was considered a borderline risk factor. Conclusion: Using an extremely OSI versus a conventional sclerotomy incision reduces the incidence of wound leakage postoperatively because of its self-sealing effect. Other factors that contribute to wound leakage, such as increased surgical duration and nonmacular diagnosis, may be indirect measurements of extensive trocar rotation, causing wound leakage despite the use of an OSI.

Original languageEnglish (US)
Pages (from-to)1101-1108
Number of pages8
JournalRetina
Volume31
Issue number6
DOIs
StatePublished - Jun 1 2011

Fingerprint

Temazepam
Vitrectomy
Wounds and Injuries
Surgical Instruments
Sutures
Case-Control Studies
Logistic Models
Regression Analysis
Incidence

Keywords

  • 23-gauge
  • oblique incision
  • risk factors
  • sutureless
  • vitrectomy
  • wound leakage

ASJC Scopus subject areas

  • Ophthalmology

Cite this

Lin, A. L., Ghate, D. A., Robertson, Z. M., O'Sullivan, P. S., May, W. L., & Chen, C. J. (2011). Factors affecting wound leakage in 23-gauge sutureless pars plana vitrectomy. Retina, 31(6), 1101-1108. https://doi.org/10.1097/IAE.0b013e3181ff0d77

Factors affecting wound leakage in 23-gauge sutureless pars plana vitrectomy. / Lin, Albert L.; Ghate, Deepta A.; Robertson, Zachary M.; O'Sullivan, Patrick Sean; May, Warren L.; Chen, Ching Jygh.

In: Retina, Vol. 31, No. 6, 01.06.2011, p. 1101-1108.

Research output: Contribution to journalArticle

Lin, AL, Ghate, DA, Robertson, ZM, O'Sullivan, PS, May, WL & Chen, CJ 2011, 'Factors affecting wound leakage in 23-gauge sutureless pars plana vitrectomy', Retina, vol. 31, no. 6, pp. 1101-1108. https://doi.org/10.1097/IAE.0b013e3181ff0d77
Lin, Albert L. ; Ghate, Deepta A. ; Robertson, Zachary M. ; O'Sullivan, Patrick Sean ; May, Warren L. ; Chen, Ching Jygh. / Factors affecting wound leakage in 23-gauge sutureless pars plana vitrectomy. In: Retina. 2011 ; Vol. 31, No. 6. pp. 1101-1108.
@article{07296adb1d0549a98703be04107b6739,
title = "Factors affecting wound leakage in 23-gauge sutureless pars plana vitrectomy",
abstract = "Purpose: To evaluate risk factors for sclerotomy leakage in 23-gauge sutureless pars plana vitrectomy in 219 patients. Methods: Nested case-control study involving 48 patients with wound leaks (visible on-table sclerotomy leakage requiring sutures) and 171 control subjects without wound leaks. Patients received either a conventional sclerotomy incision at 45°, which was then changed to 90° midincision, or an extremely oblique sclerotomy incision (OSI) at 10°, which was then changed to 30° midincision. Risk factors studied included age, gender, laterality, surgical duration, sclerotomy incision (OSI vs. conventional sclerotomy incision), preoperative diagnosis (macular vs. nonmacular), history of vitrectomy, and primary surgeon (attending vs. supervised resident). Results: Multivariate logistic regression analysis found significant (P ≤ 0.05) protective factors for wound leakage including OSI, macular preoperative diagnosis, no previous vitrectomy, and female gender. Surgical duration at least 45 minutes was considered a borderline risk factor. Conclusion: Using an extremely OSI versus a conventional sclerotomy incision reduces the incidence of wound leakage postoperatively because of its self-sealing effect. Other factors that contribute to wound leakage, such as increased surgical duration and nonmacular diagnosis, may be indirect measurements of extensive trocar rotation, causing wound leakage despite the use of an OSI.",
keywords = "23-gauge, oblique incision, risk factors, sutureless, vitrectomy, wound leakage",
author = "Lin, {Albert L.} and Ghate, {Deepta A.} and Robertson, {Zachary M.} and O'Sullivan, {Patrick Sean} and May, {Warren L.} and Chen, {Ching Jygh}",
year = "2011",
month = "6",
day = "1",
doi = "10.1097/IAE.0b013e3181ff0d77",
language = "English (US)",
volume = "31",
pages = "1101--1108",
journal = "Retina",
issn = "0275-004X",
publisher = "Lippincott Williams and Wilkins",
number = "6",

}

TY - JOUR

T1 - Factors affecting wound leakage in 23-gauge sutureless pars plana vitrectomy

AU - Lin, Albert L.

AU - Ghate, Deepta A.

AU - Robertson, Zachary M.

AU - O'Sullivan, Patrick Sean

AU - May, Warren L.

AU - Chen, Ching Jygh

PY - 2011/6/1

Y1 - 2011/6/1

N2 - Purpose: To evaluate risk factors for sclerotomy leakage in 23-gauge sutureless pars plana vitrectomy in 219 patients. Methods: Nested case-control study involving 48 patients with wound leaks (visible on-table sclerotomy leakage requiring sutures) and 171 control subjects without wound leaks. Patients received either a conventional sclerotomy incision at 45°, which was then changed to 90° midincision, or an extremely oblique sclerotomy incision (OSI) at 10°, which was then changed to 30° midincision. Risk factors studied included age, gender, laterality, surgical duration, sclerotomy incision (OSI vs. conventional sclerotomy incision), preoperative diagnosis (macular vs. nonmacular), history of vitrectomy, and primary surgeon (attending vs. supervised resident). Results: Multivariate logistic regression analysis found significant (P ≤ 0.05) protective factors for wound leakage including OSI, macular preoperative diagnosis, no previous vitrectomy, and female gender. Surgical duration at least 45 minutes was considered a borderline risk factor. Conclusion: Using an extremely OSI versus a conventional sclerotomy incision reduces the incidence of wound leakage postoperatively because of its self-sealing effect. Other factors that contribute to wound leakage, such as increased surgical duration and nonmacular diagnosis, may be indirect measurements of extensive trocar rotation, causing wound leakage despite the use of an OSI.

AB - Purpose: To evaluate risk factors for sclerotomy leakage in 23-gauge sutureless pars plana vitrectomy in 219 patients. Methods: Nested case-control study involving 48 patients with wound leaks (visible on-table sclerotomy leakage requiring sutures) and 171 control subjects without wound leaks. Patients received either a conventional sclerotomy incision at 45°, which was then changed to 90° midincision, or an extremely oblique sclerotomy incision (OSI) at 10°, which was then changed to 30° midincision. Risk factors studied included age, gender, laterality, surgical duration, sclerotomy incision (OSI vs. conventional sclerotomy incision), preoperative diagnosis (macular vs. nonmacular), history of vitrectomy, and primary surgeon (attending vs. supervised resident). Results: Multivariate logistic regression analysis found significant (P ≤ 0.05) protective factors for wound leakage including OSI, macular preoperative diagnosis, no previous vitrectomy, and female gender. Surgical duration at least 45 minutes was considered a borderline risk factor. Conclusion: Using an extremely OSI versus a conventional sclerotomy incision reduces the incidence of wound leakage postoperatively because of its self-sealing effect. Other factors that contribute to wound leakage, such as increased surgical duration and nonmacular diagnosis, may be indirect measurements of extensive trocar rotation, causing wound leakage despite the use of an OSI.

KW - 23-gauge

KW - oblique incision

KW - risk factors

KW - sutureless

KW - vitrectomy

KW - wound leakage

UR - http://www.scopus.com/inward/record.url?scp=79958289094&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=79958289094&partnerID=8YFLogxK

U2 - 10.1097/IAE.0b013e3181ff0d77

DO - 10.1097/IAE.0b013e3181ff0d77

M3 - Article

C2 - 21386764

AN - SCOPUS:79958289094

VL - 31

SP - 1101

EP - 1108

JO - Retina

JF - Retina

SN - 0275-004X

IS - 6

ER -