Evaluation of anterior segment parameters using pentacam in silicone oil–injected patients after pars plana vitrectomy.

Background: The aim of this study is to evaluate anterior segment changes with Pentacam Scheimpflug camera after pars plana vitrectomy (PPV) and silicone oil injection. Materials and Methods: In all, 44 eyes of 44 patients who underwent PPV by one surgeon were evaluated with Pentacam preoperatively, first week, and first month after surgery. The patients were divided into two groups, eyes with silicone injection after PPV and eyes with PPV and no endotamponade. Main outcome measures were preoperative and postoperative anterior chamber volume (ACV), anterior chamber depth (ACD), anterior chamber angle (ACA), and central corneal thickness (CCT) obtained with pentacam. Results: Each group consisted of 22 patients. In both groups no significant difference was detected among preop and postop changes in ACV and ACA values (P > 0.05). The increase in ACD in silicone oil–injected group and the decrease in ACD in PPV group at postop 1 week were statistically significant (P < 0.05). The increase in CCT in silicone oil–injected group at postop 1 week and then decrease in postop 1 month were also significant (P < 0.05). Surgically induced astigmatism (SIA) was 3.7 Dioptry (D) in silicone oil–injected group and 2.4 D in PPV group at postop 1 week. SIA decreased to 1.7 D and 1.5 D, respectively, at postop 1 month. Changes in SIA were significant (P < 0.05). Conclusion: PPV effects cornea and anterior segment. Changes in cornea and anterior segment after PPV seem to return to preoperative values among 1 month after surgery.

The Long-term Result of Diode Laser Transscleral Cyclophotocoagulation in the Management of Refractory Glaucoma after Intravitreal Silicone Oil Injection for Complicated Retinal Detachment

PURPOSE: To evaluate the long-term results of contact transscleral cyclophotocoagulation (TSCPC) in eyes with secondary glaucoma following intravitreal silicone oil injection. METHODS: Medical records of 18 eyes of 17 patients who underwent TSCPC following intravitreal silicone oil injection for complicated retinal detachment were reviewed. TSCPC was performed using diode laser at a power of 1.5 to 2.5 W, duration of 2 seconds, and with 14 to 27 applications. Intraocular pressure (IOP), number of glaucoma medications, status of anterior segment and retina, complications and visual acuity were evaluated. RESULTS: Overall mean number of treatments given per eye was 1.6. After a mean follow-up period of 122.7 (range, 49 to 228) weeks, the mean pretreatment IOP, 42.1+/-13.5 mmHg, decreased to 19.5+/-12.3 mmHg (p=0.001). The number of glaucoma medications was significantly decreased from 2.8+/-0.9 to 0.9+/-1.12 (p= 0.000). Hypotony or phthisis bulbi developed in one eye, respectively. Excluding the six eyes with no light perception before treatment, 4 (33.3%) of 12 eyes had stable or improved visual acuity at the final follow-up visit. Five of 8 eyes showing visual deterioration lost light perception. CONCLUSIONS: Medically uncontrolled glaucoma secondary to intravitreal silicone oil injection can be treated with TSCPC, although there is a significant risk of visual loss associated with the procedure.

The Risk Factors of Silicone Oil Induced Secondary Glaucoma

Intravitreal silicone oil injection is useful to manage the complicated retinal detachment. However, many comlications including secondary glaucoma can occur followin gsilicone oil injection. We performed this study to investigate the incidence and risk factors of silicone oil induced secondary glaucoma. The medica records of 213 eyes of 210 consecutive patients who underwent pars plana vitrectomy and silicone oil injection between January 1990 and June 1997, were reviewed retrospectivel. Fifty five of 213 eyes(25.8%) developed secondary glaucoma. The mean follow-up period was 33.4 months. The mean amount of injected silicone oil was 5.0+/-1.0ml, and 33.4 the mean numbers of operation prior to the silicone oil injection was 2.3. 65.5% of secondary glaucoma was developed within 1 year of silicone oil injection. High preoperative intraocular pressure(IOP) (p=0.004), high myopia(p=0.015) and presence of silicone oil in anterior chamber(p=0.004) increased the incidence of secondary glaucoma significantly. In conclusion, patients who have high preoperative IOP, high myopia and silicone oil in anterior chamber must be carefully followed after silicone oil injection due to high incidence of secondary glaucoma, especially during the first 1 year.