Diagnoses among the patients of this study.

Purpose
To identify risk factors for unexpected hypotony after transconjunctival sutureless vitrectomy (TSV).
Methods
In this retrospective observational study, we defined postoperative hypotony as intraocular pressure (IOP) < 6 mmHg on the day after TSV and performed multivariate analysis after dividing patients into hypotony and non-hypotony groups. Peripheral vitrectomy with scleral compression was performed for all patients and completed with normal IOP and no sutures.
Results
Eight-hundred and forty eyes of 748 consecutive patients who underwent 25-G or 27-G TSV were included. Postoperative hypotony occurred in 139 eyes (16.5%) and was associated with longer axial length (AL) (odds ratio [OR], 0.86; P = 0.001) and no tamponade usage (OR, 0.50; P = 0.001). Postoperative complications occurred more frequently in the hypotony group than in the non-hypotony group (51.1% vs. 11.3%, P < 0.001), especially choroidal fold (47.5%) and hypotony maculopathy (2.2%). On dividing patients without tamponade into 3 AL-based groups, the ≥26-mm group had significantly higher hypotony incidence than the 23–26-mm group (33.3% vs. 18.4%; P = 0.024).
Conclusion
Longer AL and no tamponade usage influenced hypotony post-TSV. In patients with these factors, especially with AL ≥ 26 mm, surgeons may aggressively consider suturing sclerotomy to minimize hypotony-related complications.

研究目的：明确经结膜无缝合玻璃体切除术（transconjunctival sutureless vitrectomy, TSV）术后意外低眼压的危险因素。
研究方法：本研究为回顾性观察研究，将TSV术后次日眼压（intraocular pressure, IOP）<6 mmHg定义为术后低眼压，将患者分为低眼压组与非低眼压组后开展多因素分析。所有患者均接受经巩膜压迫的周边玻璃体切除术，手术结束时眼压恢复正常且无需缝合切口。
研究结果：本研究共纳入748例连续就诊患者的840只眼，均接受25-G或27-G TSV治疗。其中139只眼（16.5%）发生术后低眼压，该并发症与更长的眼轴长度（axial length, AL）（比值比[OR]=0.86；P=0.001）及未使用眼内填塞（OR=0.50；P=0.001）显著相关。低眼压组术后并发症发生率显著高于非低眼压组（51.1% vs. 11.3%，P<0.001），尤以脉络膜皱褶（47.5%）和低眼压性黄斑病变（2.2%）最为常见。将未使用眼内填塞的患者按眼轴长度分为3组后，眼轴≥26mm组的低眼压发生率显著高于23~26mm组（33.3% vs. 18.4%；P=0.024）。
研究结论：更长的眼轴长度与未使用眼内填塞是TSV术后低眼压的影响因素。对于存在上述危险因素的患者，尤其是眼轴长度≥26mm者，术者可积极考虑缝合巩膜切口，以最大程度降低低眼压相关并发症的发生风险。