Intraocular pressure changes following 20G pars‐plana vitrectomy

Framme, Carsten; Klotz, Susanne; Wolf, Sebastian; Wiedemann, Peter; Wolf, Sebastián

doi:10.1111/j.1755-3768.2011.02251.x

Cited by 35 publications

(32 citation statements)

References 23 publications

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“…In 2010, Höhn and Mirshahi11 assessed IOP after ranibizumab injection, in which mean IOP was 21.2 mm Hg before injection, 54.7, 43.4 and 28.3 mm Hg at 1, 3 and 10 min after injection, respectively. In 2011, Framme et al 12 reported IOP after 20-gauge pars-plana vitrectomy. The overall cumulative hazard to reach an IOP ≥ 30 mm Hg after 24 h was 23.9%, while IOP ≥ 40 mm Hg was 8.2%.…”

Section: Discussionmentioning

confidence: 99%

The effect of steep Trendelenburg positioning on intraocular pressure and visual function during robotic-assisted radical prostatectomy

et al. 2013

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BackgroundTo evaluate intraocular pressure (IOP) changes in patients undergoing robotic-assisted radical prostatectomy and to evaluate complications from increased IOP.MethodsThirty-one eyes scheduled for robotic prostatectomy were included. Perioperative IOP measurements were performed as follows: prior to induction of anaesthesia while supine and awake (T1); immediately post-induction while supine (T2); every hour from 0 to 5 h while anaesthetised in a steep Trendelenburg position (T3–T8); prior to awakening while supine (T9); and 30 min after awakening while supine (T10). A complete ophthalmic examination including visual acuity and retinal nerve fibre layer thickness (RNFL) was performed at enrolment and 1 month postoperatively.ResultsAverage IOP (mm Hg) for each time point was as follows: T1=18.0, T2=9.8, T3=18.9, T4=21.6, T5=22.5, T6=22.3, T7=24.2, T8=24.0, T9=15.7 and T10=17.9. The proportion of eyes with intraoperative IOP ≧30 mm Hg were as follows: T3=0%, T4=3.23%, T5=9.68%, T6=6.45%, T7=22.22%, and T8=25%. Maximum IOP was 36 mm Hg. Mean visual acuity (logarithm of the minimal angle of resolution) and RNFL showed no statistically significant difference before and after operation and no other ocular complications were found at final examination.ConclusionsWhile IOP increased in a time-dependent fashion in anesthaetised patients undergoing robotic-assisted radical prostatectomy in a steep Trendelenburg position, visual function showed no significant change postoperatively and no complications were seen. Steep Trendelenburg positioning during time-limited procedures appears to pose little or no risk from IOP increases in patients without pre-existing ocular disease.

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Section: Discussionmentioning

confidence: 99%

The effect of steep Trendelenburg positioning on intraocular pressure and visual function during robotic-assisted radical prostatectomy

et al. 2013

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“…Reports in the literature have suggested intra-ocular tamponade with gas, rather than fluid, does increase the risk of post-operative pressure spikes [25]. In particular, this spike is reported to occur at 24 hours post surgery following conventional 20-gauge vitrectomy [26]. Intra-ocular tamponade with C3F8 was more common in the 20-gauge compared to the 23-gauge group (68%, 34/50, compared to 44%, 22/50).…”

Section: Discussionmentioning

confidence: 99%

Changes in Day 1 Post-Operative Intraocular Pressure Following Sutureless 23-Gauge and Conventional 20-Gauge Pars Plana Vitrectomy

Gosse¹,

Newsom²,

Hall³

et al. 2013

TOOPHTJ

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Background/Aims: The benefits associated with transconjunctival sutureless vitrectomy techniques are continuing to be defined. The purpose of this study was to compare the incidence of extreme changes in day 1 intraocular pressure (IOP) following 23-gauge sutureless vitrectomy compared with conventional 20-gauge vitrectomy.Methods: Fifty consecutive 23-gauge and 50 consecutive 20-gauge cases were included; eyes with a history of previous vitreoretinal surgery were excluded. 23-gauge surgery was completed with passive fluid air exchange where no long acting tamponade was indicated. The surgery remained sutureless unless a leak was visible at the end of the procedure. Data were collected by retrospective case note review. Statistical analysis was carried out using Fisher’s exact and chi-square tests.Results: Twenty-two percent (11/50) of 23-gauge vitrectomies required suturing of one or more ports. On the first post-operative day hypotony (IOP<5mmHg) occurred in 1/50 eyes in the 20- and 23-gauge groups. Raised pressure (IOP>21mmHg) occurred in 30% (15/50) of eyes in the 20-gauge group and 8% (4/50) of eyes in the 23-gauge group; IOP>30mmHg only occurred in the 20-gauge group (3/50).Conclusion: Fluid air exchange following 23-gauge vitrectomy is associated with very low risk of day 1 hypotony. This predominantly sutureless technique appears to reduce the incidence and magnitude of early post-operative IOP elevation compared with conventional 20-gauge vitrectomy.

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“…Framme et al [24] studied IOP after 20g surgery and found that transient low IOP was infrequent in 1.2% (10/851) of eyes. IOP after 25g surgery has been less frequently investigated.…”

Section: Discussionmentioning

confidence: 99%

23-Gauge versus 25-Gauge Vitrectomy for Proliferative Diabetic Retinopathy: A Comparison of Surgical Outcomes

2014

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Purpose: This study compared clinical outcomes and complications between 23-gauge (23g) and 25-gauge (25g) transconjunctival sutureless vitrectomy in patients with proliferative diabetic retinopathy. Study Design: It was a retrospective study using data prospectively defined and collected. 80 eyes underwent 23g transconjunctival sutureless vitrectomy, and 80 eyes underwent 25g surgery using the same vitrectomy system by one surgeon. Primary outcome measures were best-corrected visual acuity, intraocular pressure (IOP), and incidence of intraoperative and postoperative complications. Results: Vision was significantly improved after intervention in both groups (p ≥ 0.0001). There was no significant difference in visual outcomes between the groups (p = 0.43) or in the type and frequency of retinal breaks occurring during surgery (p = 0.63). The 23g group had significantly more patients with a day 1 IOP of <6 mm Hg (p = 0.034) and significantly more patients requiring a sclerostomy suture postoperatively (p = 0.014). Conclusion and Message: Both gauges are equally effective for the treatment of proliferative diabetic retinopathy.

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Intraocular pressure changes following 20G pars‐plana vitrectomy

Cited by 35 publications

References 23 publications

The effect of steep Trendelenburg positioning on intraocular pressure and visual function during robotic-assisted radical prostatectomy

The effect of steep Trendelenburg positioning on intraocular pressure and visual function during robotic-assisted radical prostatectomy

Changes in Day 1 Post-Operative Intraocular Pressure Following Sutureless 23-Gauge and Conventional 20-Gauge Pars Plana Vitrectomy

23-Gauge versus 25-Gauge Vitrectomy for Proliferative Diabetic Retinopathy: A Comparison of Surgical Outcomes

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