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Sarah Escott, Doug Baker, E Mitchel Opremcak; Combined Pars Plana Vitrectomy with Gas Tamponade and Posterior Glaucoma Tube placement in the Management of Fuchs Heterochromic Iridocyclitis complicated by secondary glaucoma. Invest. Ophthalmol. Vis. Sci. 2014;55(13):6139.
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To evaluate the surgical success of combined pars plana vitrectomy with gas tamponade and posterior glaucoma tube placement for patients with Fuchs Heterochromic Iridocyclitis complicated by secondary glaucoma.
Nonrandomized, interventional, retrospective clinical study of 14 eyes in 12 patients diagnosed with secondary glaucoma and Fuchs Heterochromic Iridocyclitis. De-identified information of patients who underwent pars plana vitrectomy with gas tamponade and posterior glaucoma tube placement between 1995-2013 were reviewed. Outcome measures included final intraocular pressure, number of glaucoma medications, incidence of post-operative complications such as hypotony and choroidal detachments, and change in visual acuity. Mean follow up time was 55.2 months for 12 of the eyes; two eyes were followed for 14 years.
All 14 patients have been followed from the date of surgery through present. Average intraocular pressure decreased from an average preoperative level of 36.8 mmHg to 12.14mmHg postoperatively (p<0.00000593). The mean number of glaucoma medications used per patient preoperatively was 2.9 and following surgery decreased to an average of 1 (p < 0.000073). Seven eyes (50%) did not require any medications post operatively. The overall success rate was 100% at one and two years. Visual acuity was improved or maintained within one line of vision in 78% of eyes. There were no surgical failures and no cases of choroidal effusion or detachment. Complications included one eye which developed late ocular hypotony and one patient who developed corneal edema.
: Combined pars plana vitrectomy with gas tamponade and glaucoma tube placement is a safe and effective procedure to decrease intraocular pressure in patients with Fuchs Heterochromic Iridocyclitis.
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