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J. J. Tseng, O. Biscette, W. M. Schiff, G. R. Barile, S. Chang; Influence of Postoperative Lens Status and Relaxing Retinotomy on Intraocular Pressure in Successful Proliferative Vitreoretinopathy Surgery. Invest. Ophthalmol. Vis. Sci. 2008;49(13):4056.
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To determine the role of relaxing retinotomy incisions and postoperative lens status upon long-term intraocular pressure outcomes in the successful anatomic repair of recurrent retinal detachment (RD) due to proliferative vitreoretinopathy (PVR).
This study included 142 eyes with recurrent RD due to PVR. Exclusion criteria were: history of giant retinal tear, uveitis, trauma, proliferative diabetic retinopathy, and age under 18 years. 96 eyes underwent retinotomy at the time of surgery, while 46 eyes were repaired without this technique. Gas (n=59) or silicone oil (n=83) was used as postoperative tamponade. Statistical analyses were performed using Fisher’s exact test.
The mean age of the patients was 62.3±13.0 years (range 25 to 92 years), and the mean follow-up time was 16.9±14.6 months (range 3 to 64 months). In all, 62 of 142 eyes were aphakic postoperatively, while 80 eyes were pseudophakic. Anatomic retinal attachment was achieved in all cases except one. In successfully reattached eyes, there was no significant difference in the rates of overall hypotony or new hypotony -- defined as postoperative hypotony in eyes that were preoperatively normotensive -- between eyes that were aphakic or pseudophakic, regardless of intraoperative retinotomy or postoperative tamponade. However, in eyes receiving retinotomy and silicone oil tamponade, there was a trend towards new hypotony in pseudophakic eyes compared to aphakic eyes [5/38 (13.2%) vs 0/29, P=0.064)]. In this particular subset of cases, there also a trend towards overall hypotony [13/38 (34.2%) vs 7/29 (24.1%), P=0.43].
In eyes undergoing relaxing retinotomy incisions during PVR surgery, lensectomy and postoperative aphakia may reduce the incidence of hypotony when silicone oil is used as a postoperative tamponade.
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