Successful management of cataract surgery associated vitreous loss with sutureless small-gauge pars plana vitrectomy

PURPOSE: To investigate the efficacy of 25-gauge self-sealing sutureless pars plana vitrectomy (PPV) in the management of vitreous loss associated with phacoemulsification. DESIGN: Retrospective noncomparative case series. METHODS: We conducted a retrospective chart review of 29 patients who underwent a newly described surgical technique, self-sealing sutureless PPV for the management of vitreous loss during phacoemulsification. The 29 eyes included in the study were analyzed for age, sex, race, posterior segment pathology, systemic illness, laterality of the eye, type of anesthesia used during surgery, placement of intraocular lens, visual acuity (pre- and postoperative), and postoperative complications. All patients had a minimum follow-up of 3 months. Self-sealing sutureless PPV was not performed in eyes with visually significant posterior segment pathology, in monocular patients, or in eyes in which there was posterior dislocation of nuclear fragments during cataract surgery. RESULTS: The final best-corrected visual acuity was 20/40 or better in 96.5% of the patients. The complication rate compared favorably with previous studies of visual outcomes after cataract surgery. CONCLUSION: Self-sealing sutureless PPV is a safe, reliable adjunct for managing vitreous loss during phacoemulsification and leads to rapid visual recovery. (C) 2004 by Elsevier Inc. All rights reserved.