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In vivo intraocular pressure monitoring during microincision vitrectomy with and without active control of infusion pressure

Abstract

Purpose

To evaluate intraocular pressure (IOP) fluctuation during vitrectomy, we directly monitored IOP in vivo using 2 vitrectomy machines with or without constant infusion pressure monitoring and control.

Methods

Among 61 eyes of 61 consecutive patients, 32 were assigned to the Accurus system (group 1) and 29 were assigned to the Constellation system (group 2) in this prospective case series. The IOP fluctuations were evaluated during routine vitrectomy procedures.

Results

The initial IOP before vitrectomy was 20.3 ± 2.4 mm Hg in group 1 using a conventional vented gas forced infusion system and 20.0 ± 0.0 mm Hg in group 2 using active IOP control at 20 mm Hg (p = 0.532). However, the average IOP change during core vitrectomy was -8.6 ± 4.3 mm Hg in group 1 and -0.8 ± 1.1 in group 2 (p<00.001). Maximum IOP was significantly decreased in group 1 (-17.0 ± 2.6 mm Hg) compared with that in group 2 (-4.1 ± 2.2 mm Hg) (p<00.001). Partial ocular collapse was observed during vitrectomy only in group 1 (78.1%). Peak IOP significantly increased during scleral compression and gas and fluid injection but was not significantly different between the groups (all p≥0.147). The IOP fluctuation range was 50-70 mm Hg in both groups.

Conclusions

The IOP fluctuated significantly during routine vitrectomy using both systems. Hypotony and partial ocular collapse were more frequently observed during vitrectomy with the Accurus system than with the Constellation system. Both systems were vulnerable to IOP surge during indentation and intravitreal injection.

Eur J Ophthalmol 2017; 27(5): 601 - 606

Article Type: ORIGINAL RESEARCH ARTICLE

DOI:10.5301/ejo.5000956

Authors

Hyun S. Yang, Young I. Yun, Jong H. Park, Sangkyung Choi, Je M. Woo

Article History

Disclosures

Financial support: Supported by a VHS Medical Center Research Grant, Republic of Korea (grant VHSMC17016). The sponsor or funding organization had no role in the design or conduct of this research.
Conflict of interest: None of the authors has conflict of interest with this submission.
Meeting presentation: Presented at the 2015 FLOREtina meeting, Florence, Italy, December 10-13, 2015.

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Authors

Affiliations

  •  Department of Ophthalmology, Seoul Shinsegae Eye Center, Eui Jung Bu, Gyeonggi-do - South Korea
  •  College of Medicine, Seoul National University, Seoul - South Korea
  •  Department of Ophthalmology, Veterans Health Service Medical Center, Seoul - South Korea
  •  Department of Ophthalmology, University of Ulsan, College of Medicine, Ulsan University Hospital, Ulsan - South Korea

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