Intraocular pressure changes during injection of microincision and conventional intraocular lenses through incisions smaller than 3.0 mm

Kamae, Kandon; Werner, Liliana; Chang, Wellington; Johnson, Jonathan T.; Mamalis, Nick

doi:10.1016/j.jcrs.2009.03.038

Cited by 8 publications

(9 citation statements)

References 32 publications

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“…The elevated IOP during IOL injection might be the initial cause of conjunctiva non-perfusion. In fact, the change of IOP during IOL implantation through a 1.9-2.5 mm incision has been documented in previous studies on cadaver or live eyes [5][6][7]. Kamae et al recorded a biphasic pattern of IOP elevation during IOL injection.…”

Section: Discussionmentioning

confidence: 89%

“…Kamae et al recorded a biphasic pattern of IOP elevation during IOL injection. The first phase of IOP elevation occurred during the optic entering the eye and the second phase occurred when the trailing haptic was pushed into the eye [5]. Kamae et al also found that the peak IOP during IOL injection might as high as 115 mmHg (double of the retinal perfusion pressure) in a successful attempt and 306 mmHg in an unsuccessful attempt [5].…”

Section: Discussionmentioning

confidence: 99%

“…The first phase of IOP elevation occurred during the optic entering the eye and the second phase occurred when the trailing haptic was pushed into the eye [5]. Kamae et al also found that the peak IOP during IOL injection might as high as 115 mmHg (double of the retinal perfusion pressure) in a successful attempt and 306 mmHg in an unsuccessful attempt [5]. We supposed that the TOSN might occur when the peak IOP during IOL injection exceeded the perfusion pressure of the conjunctival and episcleral arterioles.…”

Section: Discussionmentioning

confidence: 99%

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Transient ocular surface non-perfusion during cataract phacoemulsification surgery

2020

BMC Ophthalmol

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Background: Complete non-perfusion of the anterior segment vasculature during cataract phacoemulsification surgery is rarely reported. Case presentation: We present two cases of transient ocular surface non-perfusion (TOSN) during cataract phacoemulsification surgery. The TOSN happened during intraocular lens (IOL) implantation with complete vanish of blood flow in the conjunctival, episcleral and limbal vessels. Reperfusion started within 30 s and part of the blood supply of the conjunctiva and episclera was restored within 2 min. However, the blood flow in the limbal vessels was not restored until 5 min later. The postoperative examination of both eyes was normal. These two rare cases are the TOSN during cataract surgery. We speculated that the significantly increased intraocular pressure during IOL implantation might be the cause of this rare phenomenon. Conclusion: Non-perfusion of the ocular structures may occur if the IOP peak during IOL injection exceeds the perfusion pressure of the anterior vasculature.

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Section: Discussionmentioning

confidence: 89%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Transient ocular surface non-perfusion during cataract phacoemulsification surgery

2020

BMC Ophthalmol

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“…For individual patients, the duration, frequency and intensity level of episodes of activities in which patients engage, and other factors that are not evident from the raw survey screening responses would need to be considered. For example, although all eye rubbing elevates IOP to potentially pathological levels, the intensity of eye rubbing (and associated level of IOP elevation) can vary widely 17,19,20 as can the frequency and duration of rubbing episodes. Similarly, participation in yoga or other forms of exercising are more significant when horizontal or inverted body positions are assumed and even more so when strenuous muscular effort and altered breathing are involved.…”

Section: Discussionmentioning

confidence: 99%

An examination of the hypothesis that intraocular pressure elevation episodes can have prognostic significance in glaucoma suspects

McMonnies

2015

Journal of Optometry

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The efficacy of intraocular pressure reduction in retarding the progression of glaucoma has been demonstrated. This review examines the potential for prognostic advantage for glaucoma suspects in reducing their optic nerve head exposure to elevated intraocular pressure associated with activities which have been shown to elevate intraocular pressure. In this observational study, patients examined at the Centre for Eye Health (University of New South Wales) with a diagnosis of glaucoma suspect were surveyed to determine their histories for participation in activities which are known to elevate intraocular pressure. The evidence regarding the pathological significance of these sources of elevation in susceptible patients was examined. Apart from the universality of sleep-related intraocular pressure elevations, the histories from 183 confirmed glaucoma suspects indicate a wide range and variation in frequency of participation in other intraocular pressure elevating activities. A reduction in exposure to elevated intraocular pressure may improve the prognosis for glaucoma suspects. Additional patient specific assessment of the results of this screening could provide an indication of the degree (frequency, intensity level and duration) of exposure to elevated intraocular pressure. Such information may provide the basis for improving a patient's prognosis by helping them to identify opportunities to reduce such exposure to elevated intraocular pressure. Any benefit of reduction of such exposure appears likely to be greater if activities which elevate intraocular pressure are of long duration, occur frequently, occur over a long period of time, and/or involve high levels of intraocular pressure elevation.

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“…Stretching of the retina and choroid associated with scleral thinning and expansion usually becomes increasingly obvious at higher levels of myopia. Scleral thinning Eye rubbing: elevations up to 300 mmHg 42 and 400 mmHg. 43 Short duration (30 minutes) supine positions: mean elevation of 4.4 mmHg.…”

Section: Scleral Viscoelasticitymentioning

confidence: 99%

An examination of the baropathic nature of axial myopia

McMonnies

2014

Clinical and Experimental Optometry

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An examination of how intraocular pressure distending forces on the posterior sclera are an important mechanism in the development and progression of axial myopia has been made. Papers were selected from the results of PubMed (143) and Science Direct (1,398) searches using the key word combinations of ‘axial myopia’ and ‘intraocular pressure’. The main points include that the sclera is exposed to distending forces at all levels of physiological and pathological intraocular pressure. Reversible axial elongation is a common physiological response to elevated intraocular pressure in healthy eyes but more so in myopic eyes. Key variables, which appear to determine pathological (non‐reversible) axial elongation include the thickness, rigidity and viscoelasticity of the posterior sclera and the associated increased susceptibility of it to distending forces. Intraocular pressure appears likely to have a greater role when it is above normal. Intraocular pressure elevations, which are not detected by clinical or experimental tonometry, may be significant contributors to axial elongation. Axial elongation can be pathological in myopic or myopically predisposed eyes, when elongation is not reversible. Axial elongation has also been associated with retinal defocus in both animals and humans, when thinning due to loss of scleral collagen and/or ground substance, which is driven by the retina, appears likely to be associated with increased scleral susceptibility to intraocular pressure. As myopia progresses, signs of retinal and choroidal stretching are an increasingly apparent consequence of the balloon‐like expansion of the posterior sclera in response to intraocular pressure. Avoidance or moderation of activities which are known to elevate intraocular pressure may improve the prognosis for patients with genetic and/or environmental predisposition to myopic progression and may be an important consideration, even when other myopic control measures are being used.

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Intraocular pressure changes during injection of microincision and conventional intraocular lenses through incisions smaller than 3.0 mm

Abstract: Monitoring during implantation of both IOL types confirmed that IOP increases during insertion, including during microincision surgery using a wound-assisted technique. Further studies are necessary to evaluate the effect of pressure spikes on the optic nerve during IOL insertion.

Cited by 8 publications

References 32 publications

Transient ocular surface non-perfusion during cataract phacoemulsification surgery

Transient ocular surface non-perfusion during cataract phacoemulsification surgery

An examination of the hypothesis that intraocular pressure elevation episodes can have prognostic significance in glaucoma suspects

An examination of the baropathic nature of axial myopia

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