Anterior Chamber Collapse Following Vitreoretinal Surgery With Gas Tamponade in Aphakic Eyes

Abstract

The identification of potential risk factors in a given eye can alert the surgeon to the possibility of development of anterior chamber collapse postoperatively.

Complications Associated with the Use of Expandable Gases in Vitrectomy

“…Prone positioning might be indicated to support hole closure, as most retinal breaks develop between the posterior vitreous base and the equator [45]. With that, face-down positioning prevents forward movement of the lens-iris diaphragm caused by anterior pressure of the gas bubble, particularly in cases of floppy or atrophic iris [46–49]. Interestingly, in a study by Otsuka et al, prone position was maintained only on the day of surgery, followed by supine positioning for 7 days, and resulted in similar outcomes compared to strict prone positioning [45].…”

Impact of postoperative positioning on the outcome of pars plana vitrectomy with gas tamponade for primary rhegmatogenous retinal detachment: comparison between supine and prone positioning

“…; Rahman & Rosen ; Gopal et al. ). For this reason, patients are usually restricted to the prone position after PPV for RRD.…”

“…Given that retinal breaks commonly develop in eyes with RRD between the equatorial region and the posterior vitreous base, it is reasonable to assume that the supine position is superior to the prone position for closing of the tears in the eyes under the artificial gas tamponade following PPV from an anatomical point of view. However, the potential risks of the postoperative complications, such as increased IOP secondary to pupillary block, ACD disappearance, posterior synechia of the iris, macular pucker, retinal fold and cataract progression, are presumed to be increased if the supine position is taken while a substantial volume of gas exists (Krzystolik & D'Amico 2000; Shinoda et al 2001;Rahman & Rosen 2002;Gopal et al 2006). For this reason, patients are usually restricted to the prone position after PPV for RRD.…”

Comment on: Sandwich technique using a combination of perfluoropropane and silicone oil for inferior retinal detachment

“… In the aphakic eye was the iris diaphragm pushed forward or the anterior chamber was completely filled with gas at the end of surgery? [ 3 ] …”