Same-day versus first-day review of intraocular pressure after uneventful phacoemulsification

Tranos, Paris; Wickremasinghe, Sanjeewa; Hildebrand, Darius; Asaria, Riaz; Mearza, Ali; Ghazi-Nouri, Seyed; Little, Brian

doi:10.1016/s0886-3350(02)01649-8

Cited by 35 publications

(36 citation statements)

References 15 publications

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“…Unlike T, the K maintains the anterior chamber during the surgical procedure through viscoelastic material. However, previous research studies into the use of K during cataract surgeries have found that retained viscoelastic material in patients can result in postoperative IOP spikes [9,10]. The Goniotome (Neomedix, Tustin, CA, USA) is a new device that combines elements of both K and T. Like K, G consists of dual blades that cut into the TM tissue but they are serrated to initiate a double cut more reliably.…”

Section: Introductionmentioning

confidence: 99%

Outflow Enhancement by Three Different ab Interno Trabeculectomy Procedures in a Porcine Anterior Segment Model

Dang¹,

Wang²,

Shah³

et al. 2018

Preprint

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Objective: To evaluate three different microincisional ab interno trabeculectomy procedures in a porcine eye perfusion model. Methods:In perfused porcine anterior segments, 90 degrees of trabecular meshwork (TM) were ablated using the Trabectome (T; n=8), Goniotome (G; n=8), or Kahook device (K; n=8). After 24 hours, additional 90 degrees of TM were removed. Intraocular pressure (IOP) and outflow facility were measured at 5 µl/min and 10 µl/min perfusion to simulate an elevated IOP. Structure and function were assessed with canalograms and histology.Results: At 5 µl/min infusion rate, T resulted in a greater IOP reduction than G or K from baseline (76.12% decrease versus 48.19% and 47.96%, P=0.013). IOP reduction between G and K was similar (P=0.420). Removing another 90 degrees of TM caused an additional IOP reduction only in T and G but not in K. Similarly, T resulted in the largest increase in outflow facility at 5 µl/min compared with G and K (first ablation: 3.41 times increase versus 1.95 and 1.87; second ablation: 4.60 versus 2.50 and 1.74) with similar results at 10 µl/min (first ablation: 3.28 versus 2.29 and 1.90 (P=0.001); second ablation: 4.10 versus 3.01 and 2.01 (P=0.001)). Canalograms indicated circumferential flow beyond the ablation endpoints.Conclusions: T, G and K significantly increased the outflow facility. In this model, T had a larger effect than G and K.

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Section: Introductionmentioning

confidence: 99%

Outflow Enhancement by Three Different ab Interno Trabeculectomy Procedures in a Porcine Anterior Segment Model

Dang¹,

Wang²,

Shah³

et al. 2018

Preprint

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“…12,15,16 Cerrahi sonrası GİB artışı her ne kadar kısa süreli gibi görünse de retina sinir lifi rezervi azalmış ileri evre glokomlu hastalarda ciddi sinir lifi kaybına neden olabilir. 17 Ayrıca psödoeksfoliasyon ve pigment dispersiyonu gibi nedenlerle trabeküler dışa akımı azalmış hastalarda ya da daha yüksek koheziviteye sahip VEM'in kullanıldığı hastalarda GİB yüksekliği daha uzun sürebilir. 16,18,19 Bu risk faktör-lerine sahip hastaların cerrahi sonrası yakın takibi önerilmekle birlikte cerrahi sonrası kısa süreli GİB artışının uzun dönem görme alanı kaybına neden olmadığı birçok çalışmada gösterilmiştir.…”

Section: Discussionunclassified

“…16,18,19 Bu risk faktör-lerine sahip hastaların cerrahi sonrası yakın takibi önerilmekle birlikte cerrahi sonrası kısa süreli GİB artışının uzun dönem görme alanı kaybına neden olmadığı birçok çalışmada gösterilmiştir. 17,20 Komplikasyonsuz fakoemülsifikasyon sonrası endotel hücre kaybı kataraktın sertlik derecesi, kullanılan VEM'in ve fakoemülsifikasyon cihazı-nın özellikleri, cerrahın tecrübesi gibi birçok faktöre bağlı olarak %3-30 arasında değişmektedir. 21,22 Bu oranlar çalışmaların tama yakınında kornea merkezinden yapılan endotel hücre sayımlarına dayanmaktadır.…”

Section: Discussionunclassified

Reliability of Hydroimplantation Technique in Phacoemulsifification Surgery

Özateş¹,

Koç²

2018

Turkiye Klinikleri J Med Sci

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Ö ÖZ ZE ET T A Am ma aç ç: : Hidroimplantasyon yöntemiyle göz içi lensi (GİL) yerleştirilmesinin cerrahi sonrası göz içi basıncına (GİB) ve kadranlara göre korneal endotel hücrelerine etkisini değerlendirmek. G Ge er re eç ç v ve e Y Yö ön nt te em ml le er r: : Randomize ve prospektif çalışmaya Lens Opacities Classification System III'e göre NO2 den daha yüksek nükleer kataraktı olan, fakoemülsifikasyon ve GİL implantasyonu yapılmış 68 hastanın 68 gözü dahil edildi. Hastalar GİL implantasyonunda kullanılan tekniğe göre viskoelastik materyal (VEM) grubu ve hidroimplantasyon grubu olmak üzere 2 gruba ayrıldı. Hastaların cerrahi sonrası GİB, merkezi kornea kalınlığı (MKK), santral/superior/inferior/temporal / nazal kadranlarda endotel hücre sayıları preoperatif değerlerle karşılaştırılarak, grupların cerrahi sü-releri değerlendirildi. B Bu ul lg gu ul la ar r: : Hastaların 32'si (15 erkek, 17 kadın, ortalama yaşı: 60,9±9,9 yıl) VEM grubunda, 36'sı (17 erkek, 19 kadın, ortalama yaşı 59,0±7,8 yıl) hidroimplantasyon grubunda yer almaktaydı. Toplam cerrahi süresi VEM grubunda 8,12±1,01 dk, hidroimplantasyon grubunda 6,59±0,56 dk olup, cerrahi süre hidroimplantasyon grubunda anlamlı olarak daha düşüktü. Grupların preoperatif GİB değerleri benzer iken, postoperatif 5. saatte GİB VEM grubunda anlamlı olarak daha yüksekti. Ancak bu farkın 24. saatte kaybolduğu izlendi. Grupların MKK değerleri hem preoperatif hem de postoperatif dönemde benzerdi. Endotel hücre kaybı hidroimplantasyon grubunda tüm kadranlarda VEM grubuna göre daha fazlaydı ancak aradaki fark istatiksel olarak anlamlı değildi (santral; p=0,222; superior; p=0,091; inferior; p=0,583; temporal; p=0,089; nazal; p=0,096). İki grupta da en fazla endotel kaybı süperior kadranda izlendi. S So on nu uç ç: : Hidroimplantasyon cerrahi süresini kısaltan, cerrahi sonrası erken dönemde GİB artışını engelleyen ve endotel açısından da güvenilir bir yöntemdir. Ancak çalışma sonuçlarımız değerlendirilirken hasta populasyonunun küçük olması göz önünde bulundurulmalıdır.A An na ah h t ta ar r K Ke e l li i m me e l le er r: : Fakoemülsifikasyon; katarakt; hidroimplantasyon; endotel; viskoelastik madde A AB BS S T TR RA AC CT T O Ob bj je ec ct ti iv ve e: : To assess the effect of intraocular lens (IOL) implantation with hydroimplantation technique on postoperative intraocular pressure (IOP) and corneal endothelial cells. M Ma at te er ri ia al l a an nd d M Me et th ho od d: : This prospective randomized clinical study examined 68 eyes of 68 patients with nuclear cataract greater than NO2 according to Lens Opacities Classification System III. Patients formed viscoelastic material (VEM) and hydroimplantation groups according to technique used in IOL implantation. Preoperative and postoperative IOP, central corneal thickness (CCT), corneal endothelial cell count at central, superior, inferior, temporal and nasal cornea outcomes were analyzed and compared. R Re es su ul lt ts s: : The VEM group consisted of 32 patients (15 male, 17 female, mean age:60.9±9.9 years) and the hydroim...

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“…4 It has been shown that transient spikes in IOP have no effect on the visual field in normal patients. 22,23 However, in patients with a compromised disc, even transient elevations in IOP have been suggested to have a negative impact on patients with pre-existing severe defects. 11,20,[22][23][24][25][26][27][28][29] Yasutani et al 30 have even demonstrated that, without additional therapy, glaucomatous eyes have an elevated IOP on the first postoperative day, which can worsen until the third day before gradually decreasing.…”

Section: Discussionmentioning

confidence: 99%

“…Together with the increased susceptibility of glaucoma eyes to a transiently elevated IOP, 11,20,22,[24][25][26][27][28][29]36,38 it would appear risky to omit this 1-day postoperative check in such eyes, regardless of the prophylactic regime used.…”

Section: Discussionmentioning

confidence: 99%

Is the 1-day postoperative IOP check needed post uncomplicated phacoemulsification in patients with glaucoma and ocular hypertension?

Gupta

Vernon

2015

Eye

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Purpose To determine whether the 1-day postoperative intraocular pressure (IOP) check following routine uncomplicated phacoemulsification is necessary in patients with pre-existing glaucoma and ocular hypertension (OHT), if acetazolamide prophylaxis is used. To investigate the practice of UK glaucoma specialists in IOP rise prophylaxis and follow-up regimes.Patients and methods The IOP 1-day postoperatively was analysed against the last recorded IOP before phacoemulsification in a cohort of patients with glaucoma or OHT who underwent uncomplicated phacoemulsification cataract surgery between December 2009 and September 2012, where it was routine practice to give acetazolamide postoperatively. UK and Eire Glaucoma Society members were surveyed via an online questionnaire to analyse practice among UK glaucoma specialists. Results One hundred and seven eyes were studied: 99 with glaucoma and 8 with OHT. The mean IOP change was À 0.8 mm Hg with only two eyes measuring 430 mm Hg postoperatively (2%). Both these eyes received 750 mg acetazolamide. Eighteen (17%) eyes had an IOP rise of at least 30%. In the survey of practice there were 65 respondents. Twenty-one (32%) respondents did not use IOP prophylaxis. Only 17 (26%) of respondents routinely reviewed their patients 1-day postoperatively.Conclusion Our prophylactic acetazolamide regime does not completely eliminate the risk of an IOP 430 mm Hg on day 1 post routine phacoemulsification in glaucoma/ OHT patients. Patients with pre-existing glaucoma, despite acetazolamide prophylaxis, will require IOP management decisions on the first postoperative day after uncomplicated phacoemulsification surgery. UK expert practice is non-uniform with regard to IOP prophylaxis, and the 1-day review, and further discussion and formulation of consensus appears necessary.

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Same-day versus first-day review of intraocular pressure after uneventful phacoemulsification

Cited by 35 publications

References 15 publications

Outflow Enhancement by Three Different ab Interno Trabeculectomy Procedures in a Porcine Anterior Segment Model

Outflow Enhancement by Three Different ab Interno Trabeculectomy Procedures in a Porcine Anterior Segment Model

Reliability of Hydroimplantation Technique in Phacoemulsifification Surgery

Is the 1-day postoperative IOP check needed post uncomplicated phacoemulsification in patients with glaucoma and ocular hypertension?

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