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One-port vs. three-port diagnostic vitrectomy for posterior segment diseases of unknown origin

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Abstract

Purpose

To compare the safety and the effectiveness of one-port vs. three-port diagnostic vitrectomy in undiagnosed cases of posterior segment inflammation.

Methods

We retrospectively collected data from 80 consecutive diagnostic vitrectomies performed using a one-port (n = 40) or a three-port approach (n = 40). Cases of suspected postoperative endophthalmitis were not included in the study. Several variables were compared among groups, including length of surgery, postoperative best-corrected visual acuity (BCVA), diagnostic success and surgical complications.

Results

The mean duration of surgery was shorter in the one-port group when compared to the three-port group (15 ± 8 min vs. 49 ± 30; p = 0.0001). The patients were observed for a mean follow-up of 19 months (range 1–84). In the one-port group, the mean BCVA improved from 1.31 ± 0.96 to 0.57 ± 0.59 logarithm of minimum resolution (LogMAR) (p = 0.0009). In the three-port group, BCVA improved from 0.98 ± 0.76 to 0.51 ± 0.76 LogMAR (p = 0.0005). The difference in mean postoperative BCVA between groups was not significative at the last follow-up. One-port vitrectomy yields to a final diagnosis in 80% of the cases, and three-port vitrectomy in 48%. Most of the one-port vitrectomies were carried out under topical anesthesia. After surgery, in both groups three eyes developed a retinal detachment.

Conclusions

In this pilot study, the one-port diagnostic vitrectomy has proven to be as effective and safe as the three-port approach, allowing a reduction in surgical times. One-port diagnostic vitrectomy might be considered as the first option for those cases where more complex surgical procedures are not needed.

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Authors and Affiliations

  1. Ophthalmology, University Campus Bio-Medico, Rome, Italy

    Marco Coassin, Lorenzo Braconi, Giuseppe Mangano & Antonio Di Zazzo

  2. Department of Medical Science, Neuroscience and Sense Organs, Eye Clinic, University of Bari, Bari, Italy

    Giancarlo Sborgia

  3. Ophthalmology, AUSL-IRCCS of Reggio Emilia, Reggio Emilia, Italy

    Valentina Mastrofilippo & Luigi Fontana

  4. Ocular Immunology, AUSL-IRCCS of Reggio Emilia, Reggio Emilia, Italy

    Valentina Mastrofilippo & Luca Cimino

Authors
  1. Marco Coassin
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  2. Lorenzo Braconi
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  3. Giancarlo Sborgia
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  4. Giuseppe Mangano
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  5. Valentina Mastrofilippo
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  6. Antonio Di Zazzo
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  7. Luigi Fontana
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  8. Luca Cimino
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Correspondence to Marco Coassin.

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The authors declare that they have no competing interests.

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This study was approved by the Ethical Committee of Reggio Emilia.

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Informed consent was obtained for all patients.

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Coassin, M., Braconi, L., Sborgia, G. et al. One-port vs. three-port diagnostic vitrectomy for posterior segment diseases of unknown origin. Int Ophthalmol 40, 3217–3222 (2020). https://doi.org/10.1007/s10792-020-01504-3

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  • DOI: https://doi.org/10.1007/s10792-020-01504-3

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