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Hiroaki Ozaki, Kazuhiro Harada, Kanno Okamura, Eiichi Uchio; Intraocular pressure abnormalities following silicone oil injection for complicated retinal detachments. Invest. Ophthalmol. Vis. Sci. 2020;61(7):4378.
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Intravitreal silicone oil (SO) is used as a tamponade in the management of complicated retinal detachments. Known complications of SO are an increasing intraocular pressure (IOP), secondary glaucoma and hypotony. We have investigated the incidence and character of IOP abnormalities after pars plana vitrectomy with SO for complicated retinal detachments.
Medical records of 245 eyes of 240 patients who underwent pars plana vitrectomy combined with SO for the management of complicated retinal detachment between January 2000 and December 2018 at Fukuoka University Hospital were reviewed. The study included 159 men and 81 women. The average age was 46.0±19.1 years old. The average period of SO tamponade was 7.4±13.3 months, ranging from 0.5 to 84 months. Retinal detachment was due to proliferative vitreouretinopathy in 164 eyes, proliferative diabetic retinopathy in 27 eyes, and others including acute retina necrosis and ocular injury in 54 eyes. Patients with a history of glaucoma and an acute-onset IOP elevation within 7 days of SO injection were excluded. Hypotony was defined as IOP less than 5 mmHg. Elevated IOP was defined as 3 consecutive measurements of elevated IOP greater than 21 mmHg.
The average IOP was 10.7±4.5 mmHg before the injection of SO, and 12.1±6.2 mmHg after removal of SO. SO was not removed in 23 patients. Hypotony was found in 23 eyes (9.3%) with SO tamponade. Elevation of IOP was found in 28 eyes (11.0%). The average timing of IOP elevation was 5.6 month after SO injection. IOP resulted in normal pressure in 13/28 eyes after SO removal. Additional anti-glaucoma eye drops and/or glaucoma surgeries were carried out for 13/28 eyes with persistently high IOP. SO was not removed in 2/28 eyes because of recurrence of retinal detachments. The emulsification of SO was observed in all eyes with persistently high IOP even after the removal of SO. Emulsification of SO was statistically significant as a risk factor for persistent IOP increase (P<0.05).
SO tamponade induced hypotony in 9.3% and elevation of IOP in 11.0%. IOP was normalized after removal of SO in 50% of cases. IOP remained high after removal of SO in 50%. The emulsification of SO was a risk factor for persistent high IOP after removal of SO.
This is a 2020 ARVO Annual Meeting abstract.
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