The Open Ophthalmology Journal

ISSN: 1874-3641 ― Volume 14, 2020

Changes in Day 1 Post-Operative Intraocular Pressure Following Sutureless 23-Gauge and Conventional 20-Gauge Pars Plana Vitrectomy

Emily Gosse*, 1, Richard Newsom2, Peter Hall3 , Jonathan Lochhead4
1 Department of Ophthalmology, St Mary’s Hospital, Newport, Isle of Wight, UK
2 Department of Ophthalmology, Southampton General Hospital, Southampton, UK
3 University of Leeds, Leeds, UK
4 Department of Ophthalmology, St Mary’s Hospital, Newport, Isle of Wight, UK



The benefits associated with transconjunctival sutureless vitrectomy techniques are continuing to be defined. The purpose of this study was to compare the incidence of extreme changes in day 1 intraocular pressure (IOP) following 23-gauge sutureless vitrectomy compared with conventional 20-gauge vitrectomy.


Fifty consecutive 23-gauge and 50 consecutive 20-gauge cases were included; eyes with a history of previous vitreoretinal surgery were excluded. 23-gauge surgery was completed with passive fluid air exchange where no long acting tamponade was indicated. The surgery remained sutureless unless a leak was visible at the end of the procedure. Data were collected by retrospective case note review. Statistical analysis was carried out using Fisher’s exact and chi-square tests.


Twenty-two percent (11/50) of 23-gauge vitrectomies required suturing of one or more ports. On the first post-operative day hypotony (IOP<5mmHg) occurred in 1/50 eyes in the 20- and 23-gauge groups. Raised pressure (IOP>21mmHg) occurred in 30% (15/50) of eyes in the 20-gauge group and 8% (4/50) of eyes in the 23-gauge group; IOP>30mmHg only occurred in the 20-gauge group (3/50).


Fluid air exchange following 23-gauge vitrectomy is associated with very low risk of day 1 hypotony. This predominantly sutureless technique appears to reduce the incidence and magnitude of early post-operative IOP elevation compared with conventional 20-gauge vitrectomy.

Keywords: : Transconjunctival sutureless vitrectomy, 23-gauge vitrectomy, post-operative hypotony, post-operative IOP.

Article Information

Identifiers and Pagination:

Year: 2013
Volume: 7
First Page: 42
Last Page: 47
Publisher Id: TOOPHTJ-7-42
DOI: 10.2174/1874364101307010042

Article History:

Received Date: 10/5/2013
Revision Received Date: 13/7/2013
Acceptance Date: 17/7/2013
Electronic publication date: 21/8/2013
Collection year: 2013

© Gosse et al.; Licensee Bentham Open.

open-access license: This is an open access article licensed under the terms of the Creative Commons Attribution Non-Commercial License ( which permits unrestricted, non-commercial use, distribution and reproduction in any medium, provided the work is properly cited.

* Address correspondence to this author at the Department of Ophthalmology, St Mary’s Hospital, Newport, Isle of Wight, PO30 5TG, UK; Tel: 01983 534504; Fax: 01983 534415; E-mail:

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