Three-step incision for 23-gauge vitrectomy reduces postoperative hypotony compared with an oblique incision.

Background And Objective: to assess the efficacy and safety of the newly developed three-step incision method of performing 23-gauge vitrectomy.

Patients And Methods: a retrospective comparative study in which a consecutive series of 45 eyes that underwent the three-step incision type of 23-gauge vitrectomy was compared with a series of 27 consecutive eyes that had previously undergone the oblique incision type of 23-gauge vitrectomy.

Results: no cases of postoperative hypotony (< 6 mm Hg) were noted in the three-step group compared with 3 cases (11%) in the oblique group (P = .05). The three-step incision resulted in a significantly higher mean intraocular pressure than the conventional incision on postoperative day 1 (14.1 ± 6.7 mm Hg vs 10.9 ± 3.7 mm Hg; P = .05), but there was no significant difference after 1 week.

Conclusion: the three-step incision for performing 23-gauge vitrectomy effectively prevented postoperative hypotony and demonstrated a safety profile comparable to that of the oblique incision.