Postoperative Intraocular Pressure Abnormalities in the Silicone Study

Barr, Charles C.; Lai, May C.; Lean, John S.; Linton, Kathryn L.P.; Trese, Michael T.; Abrams, Gary W.; Ryan, Stephen J.; Azen, Stanley P.

doi:10.1016/s0161-6420(93)31425-9

Cited by 217 publications

(133 citation statements)

References 18 publications

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“…[1][2][3][4][5] Known risk factors for silicone oil-induced raised IOP include pre-existing glaucoma, diabetes, and aphakia. 2,3 The mechanism of silicone oil related glaucoma may be due to migration of emulsified oil to the anterior chamber and into the trabecular meshwork, synaechial angle closure, rubeosis iridis, pupillary block, and inflammation, or to a combination of these.…”

Section: Discussionmentioning

confidence: 99%

“…Raised intraocular pressure (IOP) remains, however, a significant complication of intraocular silicone oil with reported incidences of between 5.9 and 48% of eyes. [1][2][3][4][5] When topical medication fails to control the IOP these eyes present a challenging management problem. Silicone oil removal may result in pressure control although recent reports indicate that additional antiglaucomatous medication will still be necessary in many eyes 3,4 and that even with such additional medication over 50% of eyes will have uncontrolled intraocular pressure.…”

Section: Introductionmentioning

confidence: 99%

“…3,6 Furthermore, removal of silicone oil may be contraindicated in eyes where there is a perceived high risk of retinal redetachment or postoperative hypotony. 1 Reduction of aqueous production by ciliary body destruction is a potential method of IOP control. Cyclocryotherapy, while often effective in pressure reduction, is commonly associated with marked intraocular inflammation and is difficult to titrate with a high incidence of subsequent hypotony.…”

Section: Introductionmentioning

confidence: 99%

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Long-term results of the management of silicone oil-induced raised intraocular pressure by diode laser cycloablation

Ghazi-Nouri

Vakalis

Bloom

et al. 2004

Eye

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Aims/background To analyse the effectiveness and safety of cyclodiode treatment in eyes with silicone oil-related raised intraocular pressure (IOP) and to correlate the results with clinical features of treated eyes. Methods Retrospective review of case notes of all eyes that underwent cyclodiode treatment following injection of silicone oil at Moorfields Eye Hospital between April 1993 and January 2003 and were followed up for at least 1 year. Results In all, 38 patients were followed up for between 13 and 113 months. Totally, 17 had silicone oil in situ at the time of first treatment. The mean pretreatment IOP was 31.4 mmHg (SD 10.9), reducing to 18.6 mmHg (SD 8.6) at 1 year and to 13.9 mmHg (SD 8.4) at the final follow-up visit (Po0.001). Before treatment, 28 (73.7%) patients were on two or more topical medications. This was reduced to 18 (47.4%) patients (P ¼ 0.013) at 1 year and 13 (34.2%) patients (P ¼ 0.0007) at final follow-up. Use of oral acetazolamide for glaucoma was reduced from 16 (42.1%) patients precyclodiode to five (13.2%) patients at 1 year (P ¼ 0.0034) and three (7.9%) patients at the final visit (P ¼ 0.001). Four patients (10.5%) at 1 year and five patients (13.2%) at the final visit had hypotony (defined as IOP of less than 5 mmHg). One patient had enucleation 75 months following first cyclodiode treatment. Conclusion Diode laser photocoagulation can successfully control silicone oil-induced raised intraocular pressure where medical treatment fails. Reduction of IOP appears to be maintained long term.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Long-term results of the management of silicone oil-induced raised intraocular pressure by diode laser cycloablation

Ghazi-Nouri

Vakalis

Bloom

et al. 2004

Eye

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“…The principle anterior segment complications include cataract formation, band keratopathy and glaucoma However, it remains the favoured method of tamponade in patients with PVR and as the primary treatment in patients with giant retinal tears. 4,5 The reported incidence of glaucoma in patients with intravitreal silicone oil is variable. Barr et al 3 Figure 1 Kaplan-Meier plot of IOP survival.…”

Section: Discussionmentioning

confidence: 99%

Diode laser trans-scleral cyclophotocoagulation in the management of glaucoma in patients with long-term intravitreal silicone oil

Sivagnanavel

Ortiz-Hurtado

Williamson

2004

Eye

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Aims To analyse the results of contact transscleral cyclodiode photocoagulation (TSCPC) in reducing intraocular pressures (IOP) refractory to medical treatment in a group of patients with intravitreal silicone oil. Methods The medical records of 18 patients who received TSCPC were evaluated retrospectively. Success was evaluated primarily in terms of IOP control. Success was defined as a final IOP of less than 22 mmHg Results In all, 18 eyes of 18 patients were followed up for an average of 21.8 months (range 6-36) (SD ¼ 8.6). The mean pretreatment IOP was 39.6 mmHg (range 25-56 mmHg) (SD ¼ 9.3). This reduced to 20.0 mmHg (range 0-48, SD ¼ 13.5) after TSCPC, producing a mean reduction of 49% from mean pretreatment IOP levels. The overall success rate was 44% (eight eyes). Chronic hypotony occurred in two patients. IOP remained above that required to meet the IOP reduction criteria in eight patients. Conclusion Our results raise doubts about the efficacy of TSCPC in the management of glaucoma in eyes retaining silicone oil. This may relate to the long duration of silicone oil in our patients. Further studies are required to identify risk factors for treatment failure.

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“…1,[3][4][5][6] Anterior vitreous traction on the ciliary processes is considered to be one of the mechanisms by which hypotony is induced in post-traumatic or postvitrectomy cases. [7][8][9][10] In these cases, removing antero-posterior traction, and epiciliary membranes can lead to a moderate increase in intraocular pressure. 7,11,12 Either gas or silicone oil can be used to provide postoperative tamponade.…”

Section: Introductionmentioning

confidence: 99%

The surgical management of chronic hypotony due to uveitis

Smet

Gunning

Feenstra

2004

Eye

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Purpose Evaluate surgery in chronic hypotony secondary to uveitis. Method Retrospective analysis of six patients operated for chronic hypotony (p5 mmHg) of at least 1 month's duration. Surgery involved removal of all traction and membranes on the ciliary processes. Use of oil was limited to patients with atrophic ciliary processes. Results The average postoperative follow-up was 24 months (12-43). The average pressure increase was 7 mmHg at 6 months. Four of six uveitis patients had significantly increased vision. Conclusion Improved vision, and a sustained pressure rise are possible in hypotonous uveitis. The presence of ciliary processes is necessary. However, they do not need to be intact.

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Postoperative Intraocular Pressure Abnormalities in the Silicone Study

Cited by 217 publications

References 18 publications

Long-term results of the management of silicone oil-induced raised intraocular pressure by diode laser cycloablation

Long-term results of the management of silicone oil-induced raised intraocular pressure by diode laser cycloablation

Diode laser trans-scleral cyclophotocoagulation in the management of glaucoma in patients with long-term intravitreal silicone oil

The surgical management of chronic hypotony due to uveitis

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