Plain gut sutures reduce inflammatory response at sclerotomy sites

This single-masked, prospective study compared the performance of 2 types of sutures for sclerotomy closure after pars plana vitrectomy (PPV): plain gut and polyglactin 910.

Study design

The analysis included 49 eyes of 49 patients who were scheduled to undergo a 23-gauge PPV. Patients were randomized to sclerotomy closure with either plain gut suture, 8-0 polyglactin 910 (Vicryl) suture or a combination of both. Investigators evaluated both subjective postoperative pain and used a standardized assessment of scleral inflammation at each suture site.

Outcomes

No wound leakage was noted in either group. Scleral inflammation was significantly higher at the PG910 suture sites compared with the plain gut suture sites at both the 1-week (P=0.04) and 1-month postoperative visits (P<0.001). Patients with PG910 sutures reported greater pain at the 1-month postoperative visit than those with plain gut sutures (P=0.018).

Limitations

This study is limited by its small size, and its results may not be generalizable to all study populations. The inability to mask the graders who were assessing scleral inflammation could have resulted in bias.

Clinical significance

This prospective study supports the use of shorter-acting, less inflammatory material for sclerotomy closure. The findings show better tolerability and reduced inflammation using plain gut sutures compared with an PG910 suture to close sclerotomies.