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Short-term Outcomes of 23-gauge Pars Plana Vitrectomy

      We read with interest the article by Gupta and associates concerning their short-term outcome of one-step 23-gauge vitrectomy.
      • Gupta O.P.
      • Ho A.C.
      • Kaiser P.K.
      • et al.
      Short-term outcomes of 23-gauge pars plana vitrectomy.
      They reported that postoperative hypotony is the most frequent but transient complication after sutureless vitrectomy. However, hypotony itself is not a benign condition and may develop severe complications.
      • Fine H.F.
      • Iranmanesh R.
      • Iturralde D.
      • Spaide R.F.
      Outcomes of 77 consecutive cases of 23-gauge tranconjunctival vitrectomy surgery for posterior segment disease.
      • Chen E.
      25-Gauge transconjunctival sutureless vitrectomy.
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      References

        • Gupta O.P.
        • Ho A.C.
        • Kaiser P.K.
        • et al.
        Short-term outcomes of 23-gauge pars plana vitrectomy.
        Am J Ophthalmol. 2008; 146: 193-197
        • Fine H.F.
        • Iranmanesh R.
        • Iturralde D.
        • Spaide R.F.
        Outcomes of 77 consecutive cases of 23-gauge tranconjunctival vitrectomy surgery for posterior segment disease.
        Ophthalmology. 2007; 114: 1197-1200
        • Chen E.
        25-Gauge transconjunctival sutureless vitrectomy.
        Curr Opin Ophthalmol. 2007; 18: 188-193
        • Byeon S.H.
        • Lew Y.J.
        • Kim M.
        • Kwon O.W.
        Wound leakage and hypotony after sutureless vitrectomy: factors affecting postoperative intraocular pressure after using the 25-gauge system.
        Ophthalmic Surg Lasers Imaging. 2008; 39: 94-99
        • Byeon S.H.
        • Chu Y.K.
        • Lee S.C.
        • Koh H.J.
        • Kim S.S.
        • Kwon O.W.
        Problems associated with the 25-gauge transconjunctival sutureless vitrectomy system during and after surgery.
        Ophthalmologica. 2006; 220: 259-265
        • Lopez-Guajardo L.
        • Pareja-Esteban J.
        • Teus-Guezala M.A.
        Oblique sclerotomy technique for prevention of incompetent wound closure in transconjunctival 25-gauge vitrectomy.
        Am J Ophthalmol. 2006; 141: 1154-1156

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        American Journal of OphthalmologyVol. 146Issue 5
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          We thank Drs Byeon, Kwon, and Kang for their insightful comments about our article. Our series was similar to the published article by Byeon and associates1 in terms of cohort size and age range. Their series suggests that younger patients were at a higher risk of hypotony; however, we did not find any correlation between age and the incidence of postoperative hypotony. In our series, six eyes (6.5%) experienced postoperative hypotony with a mean age of 62 years old and a range between 47 and 81 years of age.
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