Effect of infusion air pressure on visual field defects after macular hole surgery

Hirata, Akira; Yonemura, Naoko; Hasumura, Tadashi; Murata, Yasuhiro; Negi, Akira

doi:10.1016/s0002-9394(00)00597-3

Cited by 85 publications

(59 citation statements)

References 17 publications

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“…However, in our patient, a system that constantly monitors air pressure infusion was used (The Constellation® Vision System, Alcon Laboratories) and the target pressure was set at 30 mmHg, which is the standard for the majority of vitrectomy surgeries, making this hypothesis less feasible. Indeed, Hirata et al demonstrated that reduced air pressure infusion to 30 mmHg decreased the incidence of VF defects after macular hole surgery from 24% to 4% (10) . Bansal et al posited that reduced ocular perfusion due to intraoperative systemic hypotension may be a risk factor for the development of optic neuropathy after PPV (5) .…”

Section: Discussionmentioning

confidence: 99%

Nonarteritic anterior ischemic optic neuropathy following pars plana vitrectomy for macular hole treatment: case report

Cunha¹,

Cunha²,

Costa³

et al. 2016

Arquivos Brasileiros De Oftalmologia

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Section: Discussionmentioning

confidence: 99%

Nonarteritic anterior ischemic optic neuropathy following pars plana vitrectomy for macular hole treatment: case report

Cunha¹,

Cunha²,

Costa³

et al. 2016

Arquivos Brasileiros De Oftalmologia

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“…More specifically during macular hole surgery there is evidence that FAX can be associated with visual field defects corresponding with the position and direction of this cannula [3][4][5].…”

Section: Commentmentioning

confidence: 99%

Macular Hole Eruption after Pars Plana Vitrectomy

Rainsbury¹,

Gosse²,

Lochhead³

2015

J Clin Exp Ophthalmol

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Macular hole eruption is a previously unreported complication of vitrectomy for full thickness macular hole (FTMH) repair. Keywords Macular hole; Plana vitrectomy; FTMH repair Case ReportAn 83 year old male presented with a full thickness macular hole. The visual acuity was 6/24 in the right eye, measured using a standard 6 m Snellen chart. A standard 25-Gauge 3-port (non-valved) pars plana vitrectomy, internal limiting membrane (ILM) peel and gas tamponade was performed on the right eye ( Figure 1A). The procedure was performed using the Alcon Constellation system, with the infusion pressure set at 25-35 mmHg throughout the procedure. This machine incorporates an automated IOP stabilisation system, which significantly reduces fluctuations in intraocular pressure perioperatively. After vitrectomy the ILM was stained with Dual Blue dye (under fluid). Peeling of the ILM was then commenced, without any adjustment of the IOP setting of the vitrectomy machine. During the peel stage, irrigation fluid surged from the infusion port following removal of the ILM forceps, resulting in a jet of fluid directly entering the macular hole, causing it to visibly erupt. On re-inserting the forceps the flow of fluid through the eye was stabilised.The FTMH was noted to have torn inferiorly and superiorly and a small area of localised retinal detachment was noted around the hole (Figure 2A and B). The ILM peeling was then carefully completed with removal of approximately 2 disc diameters of ILM from around the centre of the macular hole (see supplementary online video), followed by routine fluid/air/gas (C3F8 18%) exchange. No additional procedures were required for the localised retinal detachment which flattened with the intraocular gas tamponade. Postoperatively the FTMH closed ( Figure 1B) and the patient achieved 6/24 vision. Rainsbury PG et al., J Clin Exp Ophthalmol 2015, 6:1 http://dx Clinical & Experimental Ophthalmology

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“…While Haritoglou et al[ 65] and later Gass et al[ 115] stated that the incidence of visual field defects increased since they used ICG, they explained this complication by an abnormal cleavage plane and damage to the innermost retinal layers as a result of ICG staining [65]. Some clinical investigations compared the functional visual field defects with anatomical retinal changes after macular surgery without ILM peeling without any final conclusion [116, 117.] Yonemura et al [88] reported the occurrence of focal RPE changes that corresponded to visual field defects in 47% of the patients operated by vitrectomy for macular hole without ILM peeling.…”

Section: Complicationsmentioning

confidence: 99%

Intravitreal Staining of the Internal Limiting Membrane Using Indocyanine Green in the Treatment of Macular Holes

Rodrigues¹,

Meyer²,

Farah³

et al. 2005

Ophthalmologica

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Surgical management of macular holes consists of pars plana vitrectomy, removal of the posterior hyaloid facia, and peeling of the epiretinal membranes (ERM). Additionally, removal of the internal limiting membrane (ILM) may enable an increase in the anatomic and functional success rates. However, recognition of fine ILM is difficult thus increasing the time that the macula is exposed to intraoperative light. Staining the ILM with indocyanine green (ICG) dye during vitrectomy facilitates recognition of the ILM and assures that all adjacent ERM are removed. Therefore, ICG-assisted ILM peeling has gained worldwide popularity among vitreoretinal surgeons. However, there are some concerns about the intravitreal ICG application. Reports in the literature described a variety of application techniques using different concentrations. The postoperative outcomes were controversial reporting heterogeneous anatomical and functional outcomes after ICG application, as well as descriptions of adverse effects related to the dye. We discuss the indications, techniques, surgical results, and complications after intravitreal ICG injection for the treatment of macular holes.

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Effect of infusion air pressure on visual field defects after macular hole surgery

Cited by 85 publications

References 17 publications

Nonarteritic anterior ischemic optic neuropathy following pars plana vitrectomy for macular hole treatment: case report

Nonarteritic anterior ischemic optic neuropathy following pars plana vitrectomy for macular hole treatment: case report

Macular Hole Eruption after Pars Plana Vitrectomy

Intravitreal Staining of the Internal Limiting Membrane Using Indocyanine Green in the Treatment of Macular Holes

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