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PPV with oblique cannula insertion more effective than direct insertion for reducing hypotony

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Oblique cannula insertions may be better than direct cannula insertions for lowering rates of absolute and relative hypotony in the early postoperative period after 25-gauge pars plana vitrectomy without tamponade, a prospective study found.

Jason Hsu, MD, and colleagues compared IOP and rates of postoperative hypotony after performing 25-gauge pars plana vitrectomy (PPV) without tamponade using either oblique or direct cannula insertions on 95 eyes. Specifically, 55 eyes had PPV using oblique cannula insertions, and 40 eyes had PPV using direct cannula insertions.

IOP was recorded at baseline and at 1 day and 1 week postop.

With oblique insertions, the investigators found no statistically significant difference between mean IOPs measured at baseline, 1 day postop and 1 week postop, according to the study.

Only one of 55 eyes (1.8%) that received oblique cannula insertions had hypotony at 1 day postop.

With direct cannula insertions, mean IOP at 1 day postop was significantly lower than mean IOP at baseline (P = .009); however, mean IOP at baseline and at 1 week postop were similar, the study authors noted.

Of 40 eyes that received direct cannula insertions, four eyes (10%) had hypotony at 1 day postop, according to the study, published in the July-August issue of Retina.