I appreciate the opportunity to respond to the letter by Drs Milibák and Süveges about my study of "Sutureless Pars Plana Vitrectomy Through Self-sealing Sclerotomies."1 Drs Milibák and Süveges have been successful in performing sutureless vitrectomy in 7 of their patients. In the other 10 patients, at least 1 sclerotomy site required suturing. I suspect that with more persistence and through technical improvement, most of their patients could be left without suturing, In my experience, the one cause of leaking sclerotomy is a thin flap. Scleral tunnels should be created with a flap that is at least two thirds of the scleral thickness. Also, scleral tunnels should be created for a length of at least 2 mm. Long tunnels with thick flaps are unlikely to leak.
Chen JC. Complications of Sutureless Pars Plana Vitrectomy Through Self-sealing Sclerotomies—Reply. Arch Ophthalmol. 1998;116(1):119. doi: