Early and Delayed Effect of Functional Endoscopic Sinus Surgery on Intraocular Pressure

Abstract

Introduction Due to the close anatomical relationship between the paranasal sinuses and the orbit, involvement or injury of the orbit from paranasal sinuses procedures may occur. Objectives We aimed to study the early and delayed effect of endoscopic sinus surgery on intraocular pressure (IOP). Methods We included in the study 38 patients with chronic rhinosinusitis (CRS), undergoing FESS. We performed FESS with the standard anterior to posterior approach. We measured IOP at the same time one day before surgery as well as day 1 and 6 weeks after surgery. Results One day after surgery, mean IOP in the right eye was 14.176 ± 1.91 mm Hg and in the left eye was 13.79 ± 2.42 mm Hg with statistically non-significant difference from preoperative values. Six weeks postoperative, the mean IOP in the right eye was 15.14 ± 2.28 mm Hg. The difference between the mean preoperative and postoperative IOP values was found to be statistically significant (p = 0.0012). While in the left eye, mean postoperative IOP was 15.14 + 2.23mm Hg. The difference between the mean preoperative and postoperative IOP values was also found to be highly statistically significant (p = 0.0005). Conclusion Delayed significant increase in IOP can occur after FESS, Thus, special measures must be taken to reduce IOP to protect the patient́s eye from the risk of increased IOP, especially in patients with glaucoma.

The Development of Glaucoma after Surgery-Indicated Chronic Rhinosinusitis: A Population-Based Cohort Study

“…Regarding the relationship between CRS and glaucoma, delayed elevation in IOP was found in patients with CRS who received FESS [15]. Furthermore, in a previous population-based study conducted in Taiwan during a 5-year follow-up interval, CRS of all severities led to the development of OAG with a higher hazard ratio and correlated to the disease interval [16].…”

“…Regarding the ocular complications related to the development of CRS, preseptal cellulitis, orbital cellulitis, and subperiosteal abscess have been reported in a cross-sectional study [13]. Changes in intraocular pressure (IOP) in patients with CRS who received FESS has also been demonstrated [14,15], in which significantly elevated IOP was found 6 weeks after the performance of FESS [15]. Additionally, another population-based study showed the development of open-angle glaucoma (OAG) after CRS in Taiwan [16].…”

Preoperative gabapentin versus bisoprolol for haemodynamic and surgical field optimisation during endoscopic sinus surgery

“…Endoscopic sinus surgery (ESS) represents one of the most performed surgical otorhinolaryngology procedures that require good surgical field visibility. [ 1 ] Haemodynamic optimisation through heart rate (HR) control, during general anaesthesia (GA) for ESS, has been believed to be superior to reduction of systemic vascular resistance and hypotension with respect to the surgical field quality. [ 2 ] Appropriate oral premedication can provide a smooth approach to optimise the intraoperative haemodynamics without compromising patient safety.…”