[Self-sealing, sutureless sclerotomy in pars plana vitrectomy].
BACKGROUND: If sutures are used in the regular closure of sclerotomies a trauma to the bulbus can be inflicted and intraocular bleeding might result. Phases of intraocular hypotony accompany the intraoperative exchange of instruments. Like in no-stitch cataract surgery we employed this type of self-sealing wound closure in pars-plana vitrectomies. A less traumatizing technique yielding a tight and effective closure is an alternative to the conventional approach and results of our experiences are presented. MATERIALS AND METHODS: A modified approach for sutureless sclerotomy closure was applied in 50 eyes (150 sclerotomies). A sclera-covered sclerotomy is performed after preparation of adequate scleral pouches in conventional positions. A minimal conjunctival peritomy allows at the end of surgery an electric cauterization, thus using no suture material in the whole course of vitrectomy. RESULTS: Sutureless vitrectomies can only be installed in the primary operation. However, re-operations on 3 eyes were possible in the same manner using the old sclerotomy sites up to 6 weeks after initial surgery. In 12 eyes the sclerotomy had to be covered with a single suture to obtain adequate wound closure. A repetitive change of instruments during the surgical procedure is possible with this technique and all types of intraocular instruments can be employed. CONCLUSIONS: Self-sealing sclerotomies are a simple and atraumatic approach for wound closure in pars-plana vitrectomies and allow a control of intraocular pressure during surgery.