Sutured Versus Sutureless Sclerotomies after 25 Gauge Vitrectomy without an Internal Tamponade

Objective: We wished to determine whether suturing of 25 gauge sclerotomies was advantageous in maintaining normal intraocular pressure (IOP) or preventing hypotony after 25-gauge vitrectomy in eyes not requiring internal tamponade. Methods: Two-hundred seventeen consecutive 25-gauge vitrectomy surgeries from 2010 to 2013 performed at a single center by two surgeons were retrospectively reviewed. Patients were divided into 2 groups based on the surgeon's routine use of suture in such cases. Surgeon 1 (sutureless group) did not suture any sclerotomies unless intra-operative leakage was noted and surgeon 2 (sutured group) sutured all 25 gauge sclerotomies routinely. Patient data was retrieved from charts and from this we determined the mean IOP change from baseline, hypotony incidence, and complications. Results: There was no significant difference in the mean IOP change at any postoperative visits (p=0.18 at postop day 1, p=0.3 at postop week 2, p=0.23 at postop 1 month, and p=0.43 at postop month 3) between the two groups. The hypotony rate was 10.9% in surgeon 1 and 9% in surgeon 2 group at postoperative day 1 (p=0.82). One patient required suture placement at postoperative day 1 in sutureless group. No complications were seen related with hypotony at any groups. Conclusion: In our population, there is no increased risk of hypotony with sutureless transconjunctival 25-gauge vitrectomy. Suturing of non-leaking 25-gauge wounds has no effect on complications from hypotony.