Ocular Hypertension and Glaucoma Following Vitrectomy

Miele, Alba; Govetto, Andrea; Fumagalli, Carlo; Donati, Simone; Biagini, Ilaria; Azzolini, Claudio; Rizzo, Stanislao; Virgili, Gianni

doi:10.1097/iae.0000000000001651

Cited by 22 publications

(26 citation statements)

References 22 publications

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“…There was a significant increase in the IOP in operated eyes between baseline and postoperative day 2, which seems to be due to the effect of surgery itself, such as corneal edema or postoperative inflammation. In addition, as noted in previous studies [17][18][19], the IOP increase in surgically treated eyes could be attributed to the influence of FDP. Furthermore, the IOP significantly decreased between postoperative days 2 and 7 in both eyes, but the degree of descent was higher in the contralateral eyes.…”

Section: Plos Onesupporting

confidence: 71%

Intraocular pressure change with face-down positioning after macular hole surgery

2020

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This study evaluated changes in intraocular pressure (IOP) with face-down positioning (FDP) following surgical treatment of idiopathic macular hole. We retrospectively reviewed the records of 130 patients diagnosed with idiopathic macular hole who underwent pars plana vitrectomy (PPV) with intravitreal gas injection after fluid-gas exchange. We analyzed IOP changes in both eyes following FDP over the course of 7 days. The mean IOP of the operated eyes was 14.98±2.95 mmHg preoperatively and 16.82±3.12 and 15.57±6.10 mmHg on postoperative days 2 and 7, respectively. In contralateral eyes, the mean IOP changed from 14.78±3.15 mmHg preoperatively to 16.27±1.87 and 14.40±4.14 mmHg on postoperative days 2 and 7, respectively. On postoperative day 2, the IOP increased in both eyes compared to the preoperative values, but the increase was significant only in operated eyes (p = 0.039). In contralateral eyes, the IOP on postoperative day 7 was significantly decreased compared with that on postoperative day 2 (p = 0.021) and in eyes with an axial length ≥ 23.0 mm, compared with the preoperative values (p = 0.042). The IOP of the operated eyes on postoperative day 7 was higher than that of the contralateral eyes (p = 0.039). Based on a short-term follow-up, FDP after PPV with intravitreal gas tamponade for the treatment of idiopathic macular hole may cause IOP elevation not only in the operated, but also in the contralateral eyes; the IOP increase in contralateral eyes was not as significant as that in operated eyes and was not maintained over 7 days after surgery; the IOP change seems to be affected by axial length and lens status.

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Section: Plos Onesupporting

confidence: 71%

Intraocular pressure change with face-down positioning after macular hole surgery

2020

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“…We observed that with intravitreal gas absorption, the lens turns transparent again and only a few lenses cannot be restored to transparent; the pathogenesis for this state of permanent opacity needs further study [ 20 ]. The causes of ocular hypertension after vitrectomy are varied [ 21 ]. It may contribute to laser photocoagulation, combined cataract surgery, severity of postoperative vitreous hemorrhage, and use of expanding gas tamponade.…”

Section: Discussionmentioning

confidence: 99%

A Comparative Study of Vitrectomy Combined with Internal Limiting Membrane Peeling for the Treatment of Idiopathic Macular Hole with Air or C3F8 Intraocular Tamponade

Chen

Yao

Hao

et al. 2018

Journal of Ophthalmology

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Purpose The treatment of idiopathic macular holes has been basically modeled, and vitreoretinal surgery is recognized as an effective treatment. However, the postoperative tamponade of gas will still make the patient uncomfortable and may have related complications. The purpose of this study is to investigate whether air as an intraocular tamponade is equivalent to gas and what advantages may exist. Methods A retrospective study was performed in one hundred and ninety-eight patients from 2013 to 2017; 112 received gas tamponade and 86 received air tamponade. After receiving retinal surgery, the outcomes of best corrected visual acuity, intraocular pressure, slit lamp examination, fundus examination, and imaging of the macula by spectral-domain optical coherence tomography were analyzed. Results Before operation, there was no statistically significant difference in age, sex, macular hole diameter, or visual acuity between groups. The median follow-up period for the C3F8 group was 26 months, and the median follow-up for the air group was 25 months. After the operation, the best corrected visual acuity and macular hole closure rate were not significantly different between the two groups. The face-down time after the operation, the incidence of lens opacity on the third postoperative day, the intraocular pressure on the third postoperative day, and the operation time were significantly different between the two groups. Conclusions In idiopathic macular hole surgery, the effect of air as an intraocular tamponade material can be similar to that of C3F8 but has fewer complications. In particular, it is a better choice for patients for whom the face-down position is not suitable.

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“…One of the main issues when using Ozurdex as adjuvant to vitrectomy is a possible rise in IOP in the postoperative period. PPV has already been shown as an independent risk factor for the new-onset of open-angle glaucoma after surgery [156,157], and the use of Ozurdex may further boost such a risk. However, this hypothesis is speculative as there is no clear evidence on this matter in the published literature.…”

Section: Evidence Of the Efficacy Of Dex In Vitreoretinal Surgerymentioning

confidence: 98%

Intravitreal Dexamethasone Implant as a Sustained Release Drug Delivery Device for the Treatment of Ocular Diseases: A Comprehensive Review of the Literature

et al. 2020

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Drug delivery into the vitreous chamber remains a great challenge in the pharmaceutical industry due to the complex anatomy and physiology of the eye. Intravitreal injection is the mainstream route of drug administration to the posterior segment of the eye. The purpose of this review is to assess the current literature about the widening use of the intravitreal 0.7 mg dexamethasone (Dex) implant, and to provide a comprehensive collection of all the ocular disorders that benefit from Dex administration. Although anti-vascular endothelial growth-factors (VEGFs) have been largely indicated as a first-choice level, the Dex implant represents an important treatment option, especially in selected cases, such as vitrectomized eyes or patients in whom anti-VEGF failed or are contraindicated. In this article, the safety profile as well as the list of the possible complications related to intravitreal Dex injection are also discussed.

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Ocular Hypertension and Glaucoma Following Vitrectomy

Cited by 22 publications

References 22 publications

Intraocular pressure change with face-down positioning after macular hole surgery

Intraocular pressure change with face-down positioning after macular hole surgery

A Comparative Study of Vitrectomy Combined with Internal Limiting Membrane Peeling for the Treatment of Idiopathic Macular Hole with Air or C3F8 Intraocular Tamponade

Intravitreal Dexamethasone Implant as a Sustained Release Drug Delivery Device for the Treatment of Ocular Diseases: A Comprehensive Review of the Literature

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