{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,21]],"date-time":"2026-05-21T14:59:51Z","timestamp":1779375591467,"version":"3.53.1"},"reference-count":38,"publisher":"Public Library of Science (PLoS)","issue":"2","license":[{"start":{"date-parts":[[2026,2,11]],"date-time":"2026-02-11T00:00:00Z","timestamp":1770768000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:sec id=\"sec001\">\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>To evaluate the incidence of postoperative hypotony and early complications in 25-gauge vitrectomy by suturing all sclerotomies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We retrospectively reviewed a consecutive series of 458 eyes of 435 patients who underwent 25G pars plana vitrectomy with suturing all sclerotomies. The primary outcome measure was intraocular pressure (IOP) at postoperative day 1. Secondary outcome measures were clinical signs of hypotony and postoperative complications. Hypotony was defined as an IOP\u2009&lt;\u20095 mmHg.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Postoperative hypotony was found in 22 eyes (4.8%). No eyes suffered IOP of 0 nor 1 mmHg. None of the eyes demonstrated any clinical signs of hypotony including endophthalmitis, hypotony maculopathy nor choroidal detachment. The eyes with sulfur hexafluoride (SF6) gas tamponade had a significantly lower rate of hypotony compared to eyes with no tamponade (1.3% (2 eyes\/154 eyes) vs 6.3% (18eyes\/284 eyes); p\u2009=\u20090.0118). The incidence of hypotony was 11.1% (5 eyes\/45 eyes) in reoperation and 4.1% (17 eyes\/413 eyes) in primary operations (p\u2009=\u20090.037).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec004\">\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Suturing all sclerotomies showed a low incidence of postoperative hypotony. Reoperation increased the risk of hypotony, while SF6 gas tamponade lowered the risk of hypotony.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pone.0341951","type":"journal-article","created":{"date-parts":[[2026,2,11]],"date-time":"2026-02-11T18:35:40Z","timestamp":1770834940000},"page":"e0341951","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":1,"title":["Hypotony after 25-gauge pars plana vitrectomy with suturing all sclerotomies"],"prefix":"10.1371","volume":"21","author":[{"given":"Shogo","family":"Takahashi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2610-1339","authenticated-orcid":true,"given":"Tomoko","family":"Ueda-Consolvo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuta","family":"Takata","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masaaki","family":"Ishida","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shuichiro","family":"Yanagisawa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Atsushi","family":"Hayashi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2026,2,11]]},"reference":[{"issue":"10","key":"pone.0341951.ref001","first-page":"1807","article-title":"A new 25-gauge instrument system for transconjunctival sutureless vitrectomy surgery","volume":"109","author":"GY Fujii","year":"2002","journal-title":"Ophthalmology"},{"issue":"10","key":"pone.0341951.ref002","first-page":"1814","article-title":"Initial experience using the transconjunctival sutureless vitrectomy system for vitreoretinal surgery","volume":"109","author":"GY Fujii","year":"2002","journal-title":"Ophthalmology"},{"issue":"1","key":"pone.0341951.ref003","doi-asserted-by":"crossref","DOI":"10.1016\/j.ophtha.2009.06.043","article-title":"A 27-gauge instrument system for transconjunctival sutureless microincision vitrectomy surgery","volume":"117","author":"Y Oshima","year":"2010","journal-title":"Ophthalmology"},{"issue":"7","key":"pone.0341951.ref004","doi-asserted-by":"crossref","first-page":"945","DOI":"10.1136\/bjo.2006.106799","article-title":"25-gauge vs 20-gauge system for pars plana vitrectomy: a prospective randomised clinical trial","volume":"91","author":"L Kellner","year":"2007","journal-title":"Br J Ophthalmol"},{"issue":"5","key":"pone.0341951.ref005","doi-asserted-by":"crossref","first-page":"817","DOI":"10.1016\/j.ophtha.2004.11.053","article-title":"Outcomes of 140 consecutive cases of 25-gauge transconjunctival surgery for posterior segment disease","volume":"112","author":"RR Lakhanpal","year":"2005","journal-title":"Ophthalmology"},{"issue":"4","key":"pone.0341951.ref006","doi-asserted-by":"crossref","first-page":"867","DOI":"10.1007\/s10792-019-01250-1","article-title":"Comparison of 27-gauge versus 25-gauge vitrectomy results in patients with epiretinal membrane: 6-month follow-up","volume":"40","author":"W Lubi\u0144ski","year":"2020","journal-title":"Int Ophthalmol"},{"issue":"4","key":"pone.0341951.ref007","doi-asserted-by":"crossref","first-page":"472","DOI":"10.1007\/s00417-005-0173-6","article-title":"25-gauge, sutureless vitrectomy and standard 20-gauge pars plana vitrectomy in idiopathic epiretinal membrane surgery: a comparative pilot study","volume":"244","author":"S Rizzo","year":"2006","journal-title":"Graefes Arch Clin Exp Ophthalmol"},{"issue":"3","key":"pone.0341951.ref008","doi-asserted-by":"crossref","first-page":"513","DOI":"10.1016\/j.ajo.2006.03.060","article-title":"Comparison of visual function after epiretinal membrane removal by 20-gauge and 25-gauge vitrectomy","volume":"142","author":"K Kadonosono","year":"2006","journal-title":"Am J Ophthalmol"},{"issue":"4","key":"pone.0341951.ref009","doi-asserted-by":"crossref","first-page":"1575","DOI":"10.1007\/s10792-017-0625-0","article-title":"Comparative study of 27-gauge and 25-gauge vitrectomy performed as day surgery","volume":"38","author":"R Mori","year":"2018","journal-title":"Int Ophthalmol"},{"issue":"2","key":"pone.0341951.ref010","doi-asserted-by":"crossref","first-page":"155","DOI":"10.3928\/23258160-20130215-01","article-title":"Rate of hypotony following 25-gauge pars plana vitrectomy","volume":"44","author":"N Gupta","year":"2013","journal-title":"Ophthalmic Surg Lasers Imaging Retina"},{"key":"pone.0341951.ref011","article-title":"Outcomes of 27 gauge microincision vitrectomy surgery for posterior segment disease","volume":"161","author":"MA Khan","year":"2016","journal-title":"Am J Ophthalmol"},{"issue":"3","key":"pone.0341951.ref012","doi-asserted-by":"crossref","first-page":"152","DOI":"10.3928\/23258160-20220218-01","article-title":"Pars plana vitrectomy port sizes: a meta-analysis of randomized controlled trials","volume":"53","author":"YV Chaban","year":"2022","journal-title":"Ophthalmic Surg Lasers Imaging Retina"},{"issue":"4","key":"pone.0341951.ref013","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0321135","article-title":"Risk factors for hypotony after transconjunctival sutureless vitrectomy","volume":"20","author":"T Ando","year":"2025","journal-title":"PLoS One"},{"issue":"4","key":"pone.0341951.ref014","doi-asserted-by":"crossref","first-page":"518","DOI":"10.1038\/sj.eye.6702255","article-title":"Transconjunctival sutureless vitrectomy: initial experience and surgical tips","volume":"21","author":"P O\u2019 Reilly","year":"2007","journal-title":"Eye (Lond)"},{"issue":"1","key":"pone.0341951.ref015","doi-asserted-by":"crossref","first-page":"93","DOI":"10.1186\/s12886-022-02311-3","article-title":"Clinical outcomes of a beveled tip, ultra-high speed, 25-gauge pars plana vitrectomy system","volume":"22","author":"HS Uy","year":"2022","journal-title":"BMC Ophthalmol"},{"issue":"1","key":"pone.0341951.ref016","doi-asserted-by":"crossref","first-page":"156","DOI":"10.1016\/j.ajo.2010.06.042","article-title":"Hypotony after 25-gauge vitrectomy","volume":"151","author":"G Bamonte","year":"2011","journal-title":"Am J Ophthalmol"},{"issue":"3","key":"pone.0341951.ref017","doi-asserted-by":"crossref","first-page":"175","DOI":"10.47102\/annals-acadmedsg.V35N3p175","article-title":"Surgical outcomes of 25-gauge transconjunctival vitrectomy combined with cataract surgery for vitreoretinal diseases","volume":"35","author":"Y Oshima","year":"2006","journal-title":"Ann Acad Med Singap"},{"issue":"1","key":"pone.0341951.ref018","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1016\/j.jcjo.2011.12.010","article-title":"Incidence of postoperative hypotony in 25-gauge vitrectomy: oblique versus straight sclerotomies","volume":"47","author":"S Bourgault","year":"2012","journal-title":"Can J Ophthalmol"},{"issue":"5","key":"pone.0341951.ref019","doi-asserted-by":"crossref","first-page":"871","DOI":"10.1016\/j.ajo.2006.05.057","article-title":"25-gauge scleral tunnel transconjunctival vitrectomy","volume":"142","author":"H Shimada","year":"2006","journal-title":"Am J Ophthalmol"},{"issue":"6","key":"pone.0341951.ref020","doi-asserted-by":"crossref","first-page":"1109","DOI":"10.1097\/IAE.0b013e31820b5b9b","article-title":"Study of intraocular pressure after 23-gauge and 25-gauge pars plana vitrectomy randomized to fluid versus air fill","volume":"31","author":"LY Ho","year":"2011","journal-title":"Retina"},{"issue":"4","key":"pone.0341951.ref021","doi-asserted-by":"crossref","first-page":"270","DOI":"10.3928\/15428877-20070701-01","article-title":"Postoperative complications associated with 25-gauge pars plana vitrectomy","volume":"38","author":"OPI Gupta","year":"2007","journal-title":"Ophthalmic Surg Lasers Imaging"},{"issue":"2","key":"pone.0341951.ref022","doi-asserted-by":"crossref","first-page":"673","DOI":"10.1177\/1120672120902030","article-title":"Combining cataract surgery with 25-gauge high-speed pars plana vitrectomy: a prospective study","volume":"31","author":"A Savastano","year":"2021","journal-title":"Eur J Ophthalmol"},{"issue":"8","key":"pone.0341951.ref023","doi-asserted-by":"crossref","first-page":"1617","DOI":"10.1097\/IAE.0000000000000112","article-title":"Iatrogenic retinal breaks in 25-gauge vitrectomy under air compared with the standard 25-gauge system for macular diseases","volume":"34","author":"M Reibaldi","year":"2014","journal-title":"Retina"},{"issue":"1","key":"pone.0341951.ref024","doi-asserted-by":"crossref","first-page":"155","DOI":"10.1016\/j.ajo.2006.07.038","article-title":"Intraoperative sclerotomy-related retinal breaks for macular surgery, 20- vs 25-gauge vitrectomy systems","volume":"143","author":"R Scartozzi","year":"2007","journal-title":"Am J Ophthalmol"},{"issue":"9","key":"pone.0341951.ref025","doi-asserted-by":"crossref","first-page":"1261","DOI":"10.1136\/bjo.2008.140533","article-title":"Outcomes of 23- and 25-gauge transconjunctival sutureless vitrectomies for idiopathic macular holes","volume":"92","author":"S Kusuhara","year":"2008","journal-title":"Br J Ophthalmol"},{"issue":"6","key":"pone.0341951.ref026","doi-asserted-by":"crossref","first-page":"750","DOI":"10.1097\/IAE.0b013e31802c5125","article-title":"25-gauge macular surgery: results and complications","volume":"27","author":"F Patelli","year":"2007","journal-title":"Retina"},{"issue":"3","key":"pone.0341951.ref027","doi-asserted-by":"crossref","first-page":"427","DOI":"10.1016\/j.ajo.2009.04.002","article-title":"Iatrogenic retinal breaks in 25-gauge macular surgery","volume":"148","author":"HS Tan","year":"2009","journal-title":"Am J Ophthalmol"},{"issue":"9","key":"pone.0341951.ref028","doi-asserted-by":"crossref","first-page":"1188","DOI":"10.1097\/IAE.0b013e318177f9a8","article-title":"25-gauge vitrectomy using sulfur hexafluoride and no prone positioning for repair of macular holes","volume":"28","author":"PE Carvounis","year":"2008","journal-title":"Retina"},{"issue":"1","key":"pone.0341951.ref029","doi-asserted-by":"crossref","first-page":"120","DOI":"10.1016\/j.ajo.2009.08.003","article-title":"Long-term outcome of idiopathic macular hole surgery","volume":"149","author":"M Passemard","year":"2010","journal-title":"Am J Ophthalmol"},{"issue":"10","key":"pone.0341951.ref030","doi-asserted-by":"crossref","first-page":"1997","DOI":"10.1097\/IAE.0b013e31820f49ea","article-title":"Incidence of iatrogenic peripheral retinal breaks in 23-gauge vitrectomy for macular diseases","volume":"31","author":"T Nakano","year":"2011","journal-title":"Retina"},{"issue":"7","key":"pone.0341951.ref031","doi-asserted-by":"crossref","first-page":"1065","DOI":"10.1097\/IAE.0b013e3181cd48b0","article-title":"Incidence of retinal detachment after small-incision, sutureless pars plana vitrectomy compared with conventional 20-gauge vitrectomy in macular hole and epiretinal membrane surgery","volume":"30","author":"S Rizzo","year":"2010","journal-title":"Retina"},{"issue":"1","key":"pone.0341951.ref032","doi-asserted-by":"crossref","first-page":"112","DOI":"10.1097\/IAE.0b013e3181b32ebf","article-title":"Twenty-three-gauge and 20-gauge vitrectomy in epiretinal membrane surgery","volume":"30","author":"A Haas","year":"2010","journal-title":"Retina"},{"issue":"3","key":"pone.0341951.ref033","doi-asserted-by":"crossref","first-page":"262","DOI":"10.1016\/j.jcjo.2012.03.015","article-title":"The 1-year incidence of rhegmatogenous retinal detachment post 23-gauge pars plana vitrectomy","volume":"47","author":"M Rasouli","year":"2012","journal-title":"Can J Ophthalmol"},{"issue":"2","key":"pone.0341951.ref034","doi-asserted-by":"crossref","first-page":"186","DOI":"10.1001\/archopthalmol.2011.1378","article-title":"Intraoperative retinal tear formation and postoperative rhegmatogenous retinal detachment in transconjunctival cannulated vitrectomy systems compared with the standard 20-gauge system","volume":"130","author":"DJ Covert","year":"2012","journal-title":"Arch Ophthalmol"},{"issue":"5","key":"pone.0341951.ref035","doi-asserted-by":"crossref","first-page":"902","DOI":"10.1097\/IAE.0b013e3182069aa4","article-title":"Does 23-gauge sutureless vitrectomy modify the risk of postoperative retinal detachment after macular surgery? A comparison with 20-gauge vitrectomy","volume":"31","author":"J-F Le Rouic","year":"2011","journal-title":"Retina"},{"issue":"6","key":"pone.0341951.ref036","doi-asserted-by":"crossref","first-page":"1100","DOI":"10.1097\/IAE.0b013e3182349449","article-title":"Incidence of retinal breaks in eyes undergoing 23-gauge or 20-gauge vitrectomy with induction of posterior vitreous detachment","volume":"32","author":"T Hikichi","year":"2012","journal-title":"Retina"},{"issue":"5","key":"pone.0341951.ref037","doi-asserted-by":"crossref","first-page":"799","DOI":"10.5301\/ejo.5000115","article-title":"Prophylactic circumferential intraoperative laser retinopexy decreases the risk of retinal detachment after macular hole surgery","volume":"22","author":"KV Chalam","year":"2012","journal-title":"Eur J Ophthalmol"},{"issue":"6","key":"pone.0341951.ref038","first-page":"402","article-title":"Incidence of Postoperative Retinal Detachment after 25-gauge Vitrectomy for Macular Diseases","volume":"119","author":"H Nakashizuka","year":"2015","journal-title":"Nippon Ganka Gakkai Zasshi"}],"container-title":["PLOS One"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0341951","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,11]],"date-time":"2026-02-11T18:35:47Z","timestamp":1770834947000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0341951"}},"subtitle":[],"editor":[{"given":"Ogugua Ndubuisi","family":"Okonkwo","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2026,2,11]]},"references-count":38,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2026,2,11]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0341951","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2,11]]}}}