RESEARCH PAPER Keratometric alterations following the 25-gauge transconjunctival sutureless pars plana vitrectomy versus the conventional pars plana vitrectomy Clin Exp Optom 2009; 92: 5: 416–420 DOI:10.1111/j.1444-0938.2009.00400.x Mehmet Citirik MD Cosar Batman MD Tolga Bicer MD Orhan Zilelioglu MD SB Ankara Ulucanlar Eye Education and Research Hospital, Ankara, Turkey E-mail: mcitirik@hotmail.com Purpose: To assess the alterations in keratometric astigmatism following the 25-gauge transconjunctival sutureless pars plana vitrectomy versus the conventional pars plana vitrectomy. Methods: Sixteen consecutive patients were enrolled into the study. Conventional vitrectomy was applied to eight of the cases and 25-gauge transconjunctival sutureless vitrectomy was performed in eight patients. Keratometry was performed before and after the surgery. Results: In the 25-gauge transconjunctival sutureless pars plana vitrectomy group, statistically significant changes were not observed in the corneal curvature in any post- operative follow-up measurement (p > 0.05); whereas in the conventional pars plana vitrectomy group, statistically significant changes were observed in the first postoperative day (p = 0.01) and first postoperative month (p = 0.03). We noted that these changes returned to baseline in three months (p = 0.26). Conclusion: Both 25-gauge transconjunctival sutureless and conventional pars plana vitrectomy are effective surgical modalities for selected diseases of the posterior segment. Surgical procedures are critical for the visual rehabilitation of the patients. The post- operative corneal astigmatism of the vitrectomised eyes can be accurately determined at least two months post-operatively Submitted: 15 March 2009 Revised: 26 April 2009 Accepted for publication: 1 May 2009 Key words: keratometry, pars plana vitrectomy, sutureless pars plana vitrectomy Machemer and colleagues 1 developed conventional pars plana vitrectomy (PPV) to remove vitreous opacities more than three decade ago, however, his procedure led to several problems such as defec- tive healing, inflammation, suture-related problems like irritation and astigmatism encountered with vitrectomy surgery. A new technique of creating self-sealing pars plana sclerotomies was described by Chen. 2 A complete 25-gauge transcon- junctival sutureless pars plana vitrectomy TSPPV) system was first introduced in 2002 by Fujii and associates. 3 The 25- gauge TSPPV reduces the post-operative inflammation at sclerotomy sites, thus reducing patient discomfort after surgery, which is one of the biggest advantages of the surgery. 4 This surgery is mini- mally invasive; it increases the efficiency of vitrectomy, hastens postoperative re- covery and improves outcomes due to the simplified surgical procedure. The scleral incisions in conventional PPV can influence the corneal curvature and can be an important factor in the visual outcome of the surgery. Central corneal alterations are most important for the formation of the macular image and in certain conditions might produce transi- tory severe impairment of vision post- operatively. 5 Significant alterations in corneal curvature due to the scleral sutures have been reported in the early post-operative period after conventional PPV. 6 CLINICAL AND EXPERIMENTAL OPTOMETRY Clinical and Experimental Optometry 92.5 September 2009 © 2009 The Authors 416 Journal compilation © 2009 Optometrists Association Australia