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Surgical management of secondary glaucoma after pars plana vitrectomy and silicone oil injection for complex retinal detachment.
Ophthalmology. 2001 Sep; 108(9):1628-32.O

Abstract

OBJECTIVE

To evaluate the outcomes of surgical intervention for secondary glaucoma after pars plana vitrectomy and silicone oil injection for repair of complex retinal detachment.

DESIGN

Retrospective noncomparative interventional case series.

PARTICIPANTS

Forty-three eyes of 43 patients who underwent incisional surgery for secondary glaucoma after pars plana vitrectomy and silicone oil injection for repair of complex retinal detachment over a 9-year period.

MAIN OUTCOME MEASURES

Intraocular pressure (IOP), intraoperative and postoperative complications, visual acuity, and the need for further surgical intervention for glaucoma. Success was defined as IOP < or =21 mmHg and > or =5 mmHg with or without medication but without surgical reoperation for glaucoma.

RESULTS

Findings associated with elevated IOP included emulsified oil in the anterior chamber (n = 14), pupillary block from silicone oil (n = 13), open-angle glaucoma without silicone oil in the anterior chamber (n = 9), and angle-closure glaucoma without pupillary block (n = 7). The mean (+/- standard deviation) IOP was 41.4 +/- 15.1 mmHg before surgery for glaucoma and 17.2 +/- 10.2 mmHg after an average follow-up of 19.6 months (P < 0.001). Cumulative success was 69%, 60%, 56%, and 48% at 6, 12, 24, and 36-months respectively. In patients who underwent silicone oil removal alone for surgical management of glaucoma (n = 32), 11 of 12 IOP failures (92%) were due to uncontrolled IOP, whereas most IOP failures in the group who underwent silicone oil removal plus glaucoma surgery (n = 8) failed because of hypotony (3 of 4, 75%, P = 0.027). Of three patients who underwent glaucoma surgery alone to control IOP, one failed because of hypotony. There was no significant change in visual function at last follow-up (logarithm of the minimum angle of resolution [logMAR] 2.01) compared with preoperative visual function (logMAR 2.07, P = 0.74).

CONCLUSION

Surgical management of secondary glaucoma after silicone oil injection for complex retinal detachment may achieve good IOP control and stabilization of visual function in most patients. Patients who undergo silicone oil removal alone to control IOP are more likely to have persistent elevation of IOP and possibly undergo reoperation for glaucoma, whereas patients who undergo concurrent silicone oil removal and glaucoma surgery are more likely to have hypotony.

Authors+Show Affiliations

Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami School of Medicine, Miami, Florida 33136, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

11535461

Citation

Budenz, D L., et al. "Surgical Management of Secondary Glaucoma After Pars Plana Vitrectomy and Silicone Oil Injection for Complex Retinal Detachment." Ophthalmology, vol. 108, no. 9, 2001, pp. 1628-32.
Budenz DL, Taba KE, Feuer WJ, et al. Surgical management of secondary glaucoma after pars plana vitrectomy and silicone oil injection for complex retinal detachment. Ophthalmology. 2001;108(9):1628-32.
Budenz, D. L., Taba, K. E., Feuer, W. J., Eliezer, R., Cousins, S., Henderer, J., & Flynn, H. W. (2001). Surgical management of secondary glaucoma after pars plana vitrectomy and silicone oil injection for complex retinal detachment. Ophthalmology, 108(9), 1628-32.
Budenz DL, et al. Surgical Management of Secondary Glaucoma After Pars Plana Vitrectomy and Silicone Oil Injection for Complex Retinal Detachment. Ophthalmology. 2001;108(9):1628-32. PubMed PMID: 11535461.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Surgical management of secondary glaucoma after pars plana vitrectomy and silicone oil injection for complex retinal detachment. AU - Budenz,D L, AU - Taba,K E, AU - Feuer,W J, AU - Eliezer,R, AU - Cousins,S, AU - Henderer,J, AU - Flynn,H W,Jr PY - 2001/9/6/pubmed PY - 2001/9/21/medline PY - 2001/9/6/entrez SP - 1628 EP - 32 JF - Ophthalmology JO - Ophthalmology VL - 108 IS - 9 N2 - OBJECTIVE: To evaluate the outcomes of surgical intervention for secondary glaucoma after pars plana vitrectomy and silicone oil injection for repair of complex retinal detachment. DESIGN: Retrospective noncomparative interventional case series. PARTICIPANTS: Forty-three eyes of 43 patients who underwent incisional surgery for secondary glaucoma after pars plana vitrectomy and silicone oil injection for repair of complex retinal detachment over a 9-year period. MAIN OUTCOME MEASURES: Intraocular pressure (IOP), intraoperative and postoperative complications, visual acuity, and the need for further surgical intervention for glaucoma. Success was defined as IOP < or =21 mmHg and > or =5 mmHg with or without medication but without surgical reoperation for glaucoma. RESULTS: Findings associated with elevated IOP included emulsified oil in the anterior chamber (n = 14), pupillary block from silicone oil (n = 13), open-angle glaucoma without silicone oil in the anterior chamber (n = 9), and angle-closure glaucoma without pupillary block (n = 7). The mean (+/- standard deviation) IOP was 41.4 +/- 15.1 mmHg before surgery for glaucoma and 17.2 +/- 10.2 mmHg after an average follow-up of 19.6 months (P < 0.001). Cumulative success was 69%, 60%, 56%, and 48% at 6, 12, 24, and 36-months respectively. In patients who underwent silicone oil removal alone for surgical management of glaucoma (n = 32), 11 of 12 IOP failures (92%) were due to uncontrolled IOP, whereas most IOP failures in the group who underwent silicone oil removal plus glaucoma surgery (n = 8) failed because of hypotony (3 of 4, 75%, P = 0.027). Of three patients who underwent glaucoma surgery alone to control IOP, one failed because of hypotony. There was no significant change in visual function at last follow-up (logarithm of the minimum angle of resolution [logMAR] 2.01) compared with preoperative visual function (logMAR 2.07, P = 0.74). CONCLUSION: Surgical management of secondary glaucoma after silicone oil injection for complex retinal detachment may achieve good IOP control and stabilization of visual function in most patients. Patients who undergo silicone oil removal alone to control IOP are more likely to have persistent elevation of IOP and possibly undergo reoperation for glaucoma, whereas patients who undergo concurrent silicone oil removal and glaucoma surgery are more likely to have hypotony. SN - 0161-6420 UR - https://www.unboundmedicine.com/medline/citation/11535461/Surgical_management_of_secondary_glaucoma_after_pars_plana_vitrectomy_and_silicone_oil_injection_for_complex_retinal_detachment_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0161-6420(01)00658-3 DB - PRIME DP - Unbound Medicine ER -