Ultrasound Biomicroscopy after Vitrectomy in Eyes with Normal Intraocular Pressure and in Eyes with Chronic Hypotony

Nehemy, Márcio Bittar; Zisman, Márcio; Marigo, Flavio A; Nehemy, Patrícia; Schachat, Andrew P.

doi:10.1177/112067210801800419

Cited by 11 publications

(4 citation statements)

References 26 publications

(34 reference statements)

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“…However, in older people, there was a distinct reversal in the relationship between estrogen levels and IOP, with men and women exhibiting a crossover phenomenon. It supported the hypothesis that estrogen had an impact on the resistance of the out ow of aqueous humor, leading to a reduction in IOP [18,17,13] . The participants of this study were patients diagnosed with high myopia.…”

Section: Discussionsupporting

confidence: 74%

Characteristic analysis of intraocular hypertension in patients with high myopia after vitrectomy combined with silicone oil tamponade

Wang,

Chen,

Wang

et al. 2023

Preprint

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Aim: To examine the characteristics and outcomes of intraocular hypertension in patients with high myopia following vitrectomy combined with silicone oil tamponade, while also analyzing the correlated risk factors. Methods: In this retrospective study, a total of 98 patients (98 eyes) diagnosed with high myopia rhegmatogenous retinal detachment (RRD) who received their initial pars plana vitrectomy (PPV) procedure combined with silicone oil tamponade at Hebei Eye Hospital between October 2020 and November 2022 were included. In all cases, all the affected eyes received 25G standard three-channel PPV through the flat part of the ciliary body, and the retina of the affected eyes was back in place after surgery. The basic information of the patient, such as gender, eye type, diopter, and extent of net detachment were duly documented after surgery. Following the surgical procedure, a series of standard assessments were conducted, including routine visual acuity examination, anterior segment examination using a slit-lamp indirect ophthalmoscopy, and fundus examination using slit lamp indirect ophthalmoscopy. The measurement of intraocular pressure (IOP) was performed on a daily basis for a duration of one week following the surgical procedure. After that, outpatient follow-up appointments were scheduled on a monthly basis to assess IOP and conduct fundus examination using slit lamp indirect ophthalmoscopy. A minimum follow-up period of 6 months was conducted for all patients subsequent to their surgical procedures. Initially, a univariate analysis was performed to examine relevant factors, followed by a multivariate Logistic regression analysis to assess variables that had statistical significance. Results: Within the cohort of 98 patients diagnosed with high myopia and experiencing retinal detachment, there were 52 male and 46 female with the average age of (42.02±14.733) years. A total of 59 eyes (60.20%) experienced elevated IOP subsequent to PPV. 52 patients, comprising 53.06% of the participants, were seen that the administration of IOP lowering drugs resulted in the normalization of IOP. Conversely, a subset of 7 patients, accounting for 7.14% of the cohort, exhibited an inability to effectively manage IOP levels with therapeutic intervention. Among them, 5 underwent anti-glaucoma surgery (5.12%), and 2 patients (2.04%) declined the recommended surgical procedure, resulting in the persistence of elevated IOP. Patients were shown to have the highest likelihood of developing intraocular hypertension on the first, seventh, and fifth day following PPV, with corresponding probabilities of 11.00%, 11.00%, and 10.00% respectively. The results of the univariate analysis indicated significant differences in gender, IOP of the retinal detachment eye compared to the contralateral eye, and the difference in pre-operative IOP between both eyes being ≥5 mmHg (P < 0.05). No statistically significant differences were seen in terms of age, diopter, range of retinal detachment, period of retinal detachment, eye type, and whether cataract phacoemulsification was combined (P < 0.05). Binary Logistic regression analysis showed that male and preoperative binocular pressure difference ≥5mmHg were independent risk factors for early intraocular hypertension after vitrectomy, and the OR values were 2.724 and 2.52, respectively (P < 0.05). There was significant difference between the occurrence time of intraocular hypertension and the occurrence of persistent intraocular hypertension. The majority of patients who experienced intraocular hypertension within one day following surgery exhibited a temporary condition, but patients who developed intraocular hypertension between six to eight days after surgery were found to have a higher likelihood of developing permanent intraocular hypertension. Conclusions: High myopia patients diagnosed with RRD who underwent PPV together with silicone oil tamponade exhibited a higher propensity for intraocular hypertension. The majority of patients could be effectively managed with the administration of IOP lowering drugs. Males and preoperative binocular pressure difference ≥5mmHg were risk factors for intraocular hypertension. Long-term monitoring of IOP is necessary for postoperative patients in order to prevent visual damage resulting from both short-term post-operative elevation of IOP and persistent intraocular hypertension.

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Section: Discussionsupporting

confidence: 74%

Characteristic analysis of intraocular hypertension in patients with high myopia after vitrectomy combined with silicone oil tamponade

Wang,

Chen,

Wang

et al. 2023

Preprint

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“…17 Hypotony in the settings of severe ocular trauma, infection, recurrent retinal detachment, multiple surgeries, and ongoing intraocular inflammation 18 can be secondary to posterior forces transmitted to the ciliary body as occurring in proliferative vitreoretinopathy and/or fibrotic contraction associated with anterior structures (particularly in pediatric cases) with transmission of forces to aqueous-producing structures. 19 Proliferative vitreoretinopathy leads to formation and contraction of vitreous bands and membranes, which in turn leads to further retinal detachment and pulling on the ciliary body and ciliary epithelium-inducing secretory hypofunction, hypotony, phthisis bulbi, and permanent blindness. 20 In our patients, a preoperative high resolution B-scan sonogram revealed traction bands in the vitreous cavity of all patients and one of the patients had total retinal detachment.…”

Section: Discussionmentioning

confidence: 99%

Permanent Keratoprosthesis Combined With Pars Plana Vitrectomy and Silicone Oil Injection for Visual Rehabilitation of Chronic Hypotony and Corneal Opacity

Utine

Gehlbach

Zimmer-Galler

et al. 2010

Cornea

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“…184 A total of 20 eyes with normal IOP after vitrectomy were used as controls. Ciliary body alterations are thought to be the cause of reduced aqueous production.…”

Section: Retinal Reattachment: General Surgical Principles and Technimentioning

confidence: 99%

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Wong¹,

Wong²

2013

Retina

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Ultrasound Biomicroscopy after Vitrectomy in Eyes with Normal Intraocular Pressure and in Eyes with Chronic Hypotony

Abstract: Eyes with hypotony following PPV have CB abnormalities that can be detected by UBM. These CB alterations were not found in eyes with normal IOP after PPV in this series.

Cited by 11 publications

References 26 publications

Characteristic analysis of intraocular hypertension in patients with high myopia after vitrectomy combined with silicone oil tamponade

Characteristic analysis of intraocular hypertension in patients with high myopia after vitrectomy combined with silicone oil tamponade

Permanent Keratoprosthesis Combined With Pars Plana Vitrectomy and Silicone Oil Injection for Visual Rehabilitation of Chronic Hypotony and Corneal Opacity

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