Intraocular Pressure Assessment in Gas-Filled Eyes Following Vitrectomy

Poliner, Lon S.; Schoch, Lawrence H.

doi:10.1001/archopht.1987.01060020054027

Cited by 28 publications

(8 citation statements)

References 11 publications

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“…One of the most frequent complications related to the use of intraocular gas is elevation of intraocular pressure, and high intraocular pressure can result in vascular occlusion or optic nerve damage (Poliner & Schoch 1987;Cekic & Ohji 2000). Those effects are more profound in patients with prior optic nerve damage or glaucoma.…”

Section: Introductionsupporting

confidence: 40%

Intraoperative assessment of intraocular pressure in vitrectomized air-filled and fluid-filled eyes

Moon

Choi

Rhee³

et al. 2013

Acta Ophthalmol

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ABSTRACT.Purpose: To ascertain the difference of intraocular pressure (IOP) measurement between vitrectomized air-filled and fluid-filled eyes. Methods: Thirty-one eyes of 31 consecutive patients who underwent conventional vitrectomy and intraocular gas tamponade were assessed. After vitrectomy, IOP of the fluid-filled eyes was measured by Tono-Pen. Thereafter, fluid-air exchange was performed, and IOP of the air-filled eyes was measured again. The IOP within each fluid-and air-filled eye was varied by selecting settings on the vitrectomy system, from 10 to 50 mmHg with 5-mmHg increments. Postoperatively, IOP was assessed by both Tono-Pen and Goldmann applanation tonometry (GAT). Linear and nonlinear regression analyses were conducted between intraoperatively measured Tono-Pen readings and actual IOPs. Bland-Altman plot was used to assess the agreements between postoperatively measured Tono-Pen readings and GAT readings. Results: The discrepancy between Tono-Pen readings and actual IOP in fluidfilled eyes was not significant, except for the profound high pressures over 45 mmHg. However, Tono-Pen readings in air-filled eyes were significantly lower than actual IOPs in all ranges, and Tono-Pen increasingly underestimates IOP at higher levels. Intraoperative Tono-Pen readings were correlated significantly with actual IOP and a quadratic equation evidenced the best fit (R 2 = 0.996). Postoperatively, difference of the measurements between TonoPen and GAT was not significant. Conclusion: Tono-Pen and GAT significantly underestimate actual IOP in airfilled eyes. It should be considered that actual IOP would be greater than the measured IOP in gas-filled eyes, even though the IOP is measured as normal.

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Section: Introductionsupporting

confidence: 40%

Intraoperative assessment of intraocular pressure in vitrectomized air-filled and fluid-filled eyes

Moon

Choi

Rhee³

et al. 2013

Acta Ophthalmol

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“…Therefore, patients with intravitreal gas should be discouraged from traveling to high altitudes. IOP measurements should be performed with Goldmann applanation tonometry or Perkins tonometry, since pneumatic and Schiøtz indentation tonometry may underestimate IOP in gas-filled eyes [43– 45]. …”

Section: Glaucoma After Intravitreal Gas Injectionmentioning

confidence: 99%

Glaucoma management after vitreoretinal surgeries

Kornmann

Gedde

2016

Current Opinion in Ophthalmology

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Purpose of review The surgical management of retinal disorders, including scleral buckling procedures, pars plana vitrectomy, and intravitreal injections of gas or silicone oil, can lead to short-term elevations in intraocular pressure (IOP) and ultimately long-term glaucomatous damage if not treated in a timely manner. Glaucoma in these cases is commonly refractory to conventional therapies. This review highlights the treatment strategies for glaucoma in eyes that have previously undergone vitreoretinal surgery. Recent findings Although medical therapy is often used initially to control a temporary rise in IOP, laser and surgical therapy may be required to treat sustained IOP elevation and subsequent glaucomatous damage in eyes that have undergone intraocular surgery for retinal disorders. Glaucoma drainage devices are an important treatment modality, particularly when there is high risk of failure with filtering surgery. Summary Previous vitreoretinal surgery is a known risk factor for the development of glaucoma. Treatment is usually initiated with medical therapy, however, surgical intervention is frequently required to control IOP and prevent progressive glaucomatous damage in patients with refractory glaucoma.

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“…IOP should be measured by using the Goldmann applanation tonometer (Haag-Streit AG, Koeniz, Switzerland) or Perkins tonometer (Haag-Streit AG, Koeniz, Switzerland). Pneumatic and Schiotz’ indentation tonometry may underestimate IOP 39–41. Mild IOP elevation may occur within the first 24 hours, responding usually to topical aqueous suppressants or oral carbonic anhydrase inhibitors within a few days.…”

Section: Intravitreal Gas Injectionmentioning

confidence: 99%

Glaucoma associated with the management of rhegmatogenous retinal detachment

Mangouritsas¹,

Mourtzoukos²,

Portaliou³

et al. 2013

OPTH

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Transient or permanent elevation of intraocular pressure (IOP) is a common complication following vitreoretinal surgery. Usually secondary glaucoma, which develops after scleral buckling procedures, or pars plana vitrectomy for repair of rhegmatogenous retinal detachment, is of multifactorial origin. It is essential, for appropriate management, to detect the cause of outflow obstruction. An exacerbation of preexisting open-angle glaucoma or a steroid-induced elevation of IOP should also be considered. Scleral buckling may be complicated by congestion and anterior rotation of the ciliary body resulting in secondary angle closure, which can usually resolve with medical therapy. The use of intravitreal gases may also induce secondary angle-closure with or without pupillary block. Aspiration of a quantity of the intraocular gas may be indicated. Secondary glaucoma can also develop after intravitreal injection of silicone oil due to pupillary block, inflammation, synechial angle closure, or migration of emulsified silicone oil in the anterior chamber and obstruction of the aqueous outflow pathway. In most eyes medical therapy is successful in controlling IOP; however, silicone oil removal with or without concurrent glaucoma surgery may also be required. Diode laser transscleral cyclophotocoagulation and glaucoma drainage devices constitute useful treatment modalities for long-term IOP control. Cooperation between vitreoretinal and glaucoma specialists is necessary to achieve successful management.

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Intraocular Pressure Assessment in Gas-Filled Eyes Following Vitrectomy

Cited by 28 publications

References 11 publications

Intraoperative assessment of intraocular pressure in vitrectomized air-filled and fluid-filled eyes

Intraoperative assessment of intraocular pressure in vitrectomized air-filled and fluid-filled eyes

Glaucoma management after vitreoretinal surgeries

Glaucoma associated with the management of rhegmatogenous retinal detachment

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