Purpose: To assess the alterations in conjunctival impression cytology following 23-gauge transconjunctival sutureless versus conventional pars plana vitrectomy. Patients and Methods: Sixty consecutive patients were enrolled in the study. Conjunctival impression cytology was performed on 30 eyes (of 30 subjects) with 23-gauge transconjunctival sutureless vitrectomy and on 30 eyes (of 30 subjects) with conventional vitrectomy. Conjunctival impression cytology was performed preoperatively on the 1st day and in the 3rd month after the surgery. Impression cytology specimens of each group were graded and scored using a range of 0-3 according to Nelson's method. Results: In the conventional pars plana vitrectomy group, statistically significant alterations in the conjunctival impression cytology were detected on the 1st postoperative day (p = 0.001) and in the 3rd postoperative month (p = 0.001), whereas in the 23-gauge transconjunctival sutureless pars plana vitrectomy group, statistically significant changes were observed on the 1st postoperative day. However, no significant changes were observed in the following 3 postoperative months (p = 0.08). Conclusion: The properties of impression cytology were altered in the early postoperative period after sutureless and conventional vitrectomy. These changes were improved in the sutureless vitrectomy group only. Sutureless vitrectomy also had an advantageous effect on the conjunctival cytological changes and conjunctival structure.

Keywords:
23-Gauge transconjunctival sutureless pars plana vitrectomy, Conjunctiva, Conventional pars plana vitrectomy, Impression cytology
1.
Milibak T, Suveges I: Complications of sutureless pars plana vitrectomy through self-sealing sclerotomies. Arch Ophthalmol 1998;116:119.
2.
Kwok AK, Tham CC, Lam DS, Li M, Chen JC: Modified sutureless sclerotomies in pars plana vitrectomy. Am J Ophthalmol 1999;127:731-733.
3.
Eckardt C: Transconjunctival sutureless 23-gauge vitrectomy. Retina 2005;25:208-211.
4.
Park DH, Shin JP, Kim SY: Surgically induced astigmatism in combined phacoemulsification and vitrectomy; 23-gauge transconjunctival sutureless vitrectomy versus 20-gauge standard vitrectomy. Graefes Arch Clin Exp Ophthalmol 2009;247:1331-1337.
5.
Egbert PR, Lauber S, Maurice MD: A simple conjunctival biopsy. Am J Ophthalmol 1977;84:798-801.
6.
Julio G, Lluch S, Pujol P, Alonso S, Merindano D: Tear osmolarity and ocular changes in pterygium. Cornea 2012;31:1417-1421.
7.
Nelson JD, Havener VR, Cameron JD: Cellulose acetate impression of ocular surface. Dry eye states. Arch Ophthalmol 1983;101:1869-1972.
8.
Gill GW, Frost JK, Miller KA: A new formula for a half-oxidized hematoxylin solution that neither overstains nor requires differentiation. Acta Cytol 1974;18:300-311.
9.
Machemer R, Buettner H, Norton EW, Parel JM: Vitrectomy: a pars plana approach. Trans Am Acad Ophthalmol Otolaryngol 1971;75:813-820.
10.
Wirbelauer C, Hoerauf H, Roider J, Laqua H: Corneal shape changes after pars plana vitrectomy. Graefes Arch Clin Exp Ophthalmol 1998;236:822-828.
11.
Hikichi T, Matsumoto N, Ohtsuka H, Higuchi M, Matsushita T, Ariga H, Kosaka S, Matsushita R: Comparison of one-year outcomes between 23- and 20-gauge vitrectomy for preretinal membrane. Am J Ophthalmol 2009;147:639-643.e1.
12.
Rivas L, Oraza MA, Perez-Esteban A, Murube-del-Castillo J: Morphological changes in ocular surface in dry eyes and other disorders by impression cytology. Graefes Arch Ophthalmol 1992;230:329-334.
13.
Tseng SCG: Staging of conjunctival squamous metaplasia by impression cytology. Ophthalmology 1985;92:728-733.
14.
Maumenee AE: Keratinization of the conjunctiva. Trans Am Ophthalmol Soc 1979;77:133-143.
15.
Rolando M, Brezzo V, Giordano G, Campagna P, Burlando S, Calabria G: The effect of different benzalkonium chloride concentrations on human normal ocular surface: a controlled prospective impression cytology study; in Van Bijsterveld OP, Lemp MA, Spinelli D (eds): The Lacrimal System. Amsterdam, Kugler, 1991, pp 89-91.
16.
Misra A, Ho-Yen G, Burton RL: 23-Gauge sutureless vitrectomy and 20-gauge vitrectomy: a case series comparison. Eye (Lond) 2009;23:1187-1191.
17.
Isenberg SJ, McRee WE, Jedrzynski MS: Conjunctival hypoxia in diabetes mellitus. Invest Ophthalmol Vis Sci 1986;27:1512-1515.
18.
Worthen DM, Fenton BM, Rosen P, Zweifach B: Morphometry of diabetic conjunctival blood vessels. Ophthalmology 1981;88:655-657.
19.
Fink S, Ray CW, McCartney S, Ehrlich H, Shoemaker WC: Oxygen transport and utilization in hyperoxia and hypoxia: relation of conjunctival and transcutaneous oxygen tensions to hemodynamic and oxygen transport variables. Crit Care Med 1984;12:943-948.
20.
Citirik M, Batman C, Bicer T, Zilelioglu O: Keratometric alterations following the 25-gauge transconjunctival sutureless pars plana vitrectomy versus the conventional pars plana vitrectomy. Clin Exp Optom 2009;92:416-420.
21.
Kocak N, Lebe B, Selver OB, Zengin MO, Kaynak S: Histological changes in the healing process of sclerotomy sites after 20-gauge and transconjunctival 23- and 25-gauge incisions in experimental model. Turk J Med Sci 2011;41:1013-1019.
© 2015 S. Karger AG, Basel
2015
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.