Time Course of Changes in Aqueous Flare Intensity After Vitrectomy for Rhegmatogenous Retinal Detachment

Hoshi, Sujin; Okamoto, Fumiki; Hasegawa, Yumi; Sugiura, Yoshimi; Okamoto, Yoshifumi; Hiraoka, Takahiro; Oshika, Tetsuro

doi:10.1097/iae.0b013e3182456f38

Cited by 20 publications

(17 citation statements)

References 33 publications

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“…These opinions are consistent with those from publications that used LFM values to quantify inflammation with corticosteroid treatment 1 month after cataract surgery (10–18 photons/ms),38–441 week after PPV for ERM (16–18 photons/ms),56 and 1 week, 1 month and 3 months after RD surgery (45, 23 and 17 photons/ms, respectively) 57. Interestingly, there are no data available in the literature for LFM values after glaucoma surgery since postoperative inflammation has been evaluated only by an inflammation score, conjunctival hyperaemia, bleb scarring and complications such as hypopyon and synechiae.…”

Section: Discussionsupporting

confidence: 89%

Management of postoperative inflammation after cataract and complex ocular surgeries: a systematic review and Delphi survey

Aptel

Colin

Kaderli³

et al. 2017

Br J Ophthalmol

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Prevention and management of postoperative ocular inflammation with corticosteroids and non-steroidal anti-inflammatory drugs (NSAIDs) have been evaluated in several randomised controlled trials (RCTs). However, neither consensus regarding the efficacies of different regimens nor established guidelines are currently available. This has resulted in different practice patterns throughout the world. A systematic literature review found that for the management of postcataract inflammation nepafenac produced a positive outcome in three of three RCTs (3/3), as did ketorolac (1/1), bromfenac (7/7), loteprednol (3/3) and difluprednate (6/6), but not flurbiprofen (0/1). A single study found that betamethasone produced inconclusive results after retinal detachment (RD) surgery; ketorolac was effective (1/1) after vitrectomy, but triamcinolone was ineffective (0/1) after trabeculectomy. A two-round Delphi survey asked 28 international experts to rate both the inflammatory potential of different eye surgeries and their agreement with different treatment protocols. They rated trabeculectomy, RD surgery and combined phacovitrectomy as more inflammatory than cataract surgery. Vitrectomies for macular hole or epiretinal membrane were not deemed more inflammatory than cataract surgery. For trabeculectomy, they preferred to treat longer than for cataract surgery (NSAID + corticosteroid three times a day for 2 months vs 1 month). For vitrectomy alone, RD surgery and combined phacovitrectomy, the panel preferred the same treatment as for cataract surgery (NSAID + corticosteroid three times a day for 1 month). The discrepancy between preferred treatment and perception of the eye's inflammatory status by the experts for RD and combined vitreoretinal surgeries highlights the need for RCTs to establish treatment guidelines.

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Section: Discussionsupporting

confidence: 89%

Management of postoperative inflammation after cataract and complex ocular surgeries: a systematic review and Delphi survey

Aptel

Colin

Kaderli³

et al. 2017

Br J Ophthalmol

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“…Our study supports previous research showing that aqueous flare was higher in eyes with RRD than eyes without RRD, higher in eyes with macula-off RRD than macula-on RRD, associated with IOP, and not associated with RRD duration (Hoshi et al 2012). Furthermore, although the effects of RRD on ocular circulation are not well understood and are still open to debate, a temporary reduction in retinal tissue blood flow has been reported in the macula of eyes with macula-on RRD (Eshita et al 2004).…”

supporting

confidence: 94%

Anterior chamber aqueous flare and optic nerve microcirculation in eyes with rhegmatogenous retinal detachment

Yui

Kunikata

Aizawa

et al. 2016

Acta Ophthalmologica

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“…Although postoperative aqueous flare cell in the 27G group recovered to the baseline value 90 days postoperatively, those in the 25G group did not, even 180 days postoperatively. Hoshi et al 18 reported that aqueous flare intensity after vitrectomy for rhegmatogenous retinal detachment decreased to a stable level 3 months postoperatively but remained significantly higher than the normal level even after 12 months. These results suggest that 27G vitrectomy for ERM causes less surgical trauma to the eye than 25G vitrectomy; however, a significant difference was not seen between the two groups.…”

Section: Discussionmentioning

confidence: 99%

Comparative study of 27-gauge vs 25-gauge vitrectomy for epiretinal membrane

Mitsui

Kogo

Takeda

et al. 2016

Eye

100

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PurposeThe purpose of this study was to compare 27-gauge (27G) with 25-gauge (25G) microincision vitrectomy in patients with epiretinal membrane (ERM).ParticipantsSeventy-four eyes of 66 patients undergoing 3-port pars plana vitrectomy using 27G or 25G instrumentation.MethodsSeventy-four eyes of 66 patients with ERM, who underwent 27G or 25G microincision vitrectomy were prospectively evaluated.ResultsThe mean operation time for vitrectomy was significantly longer in the 27G group than in the 25G group (9.9±3.5 vs 6.2±2.7 min, respectively, P<0.0001). No statistically significant difference was found between the two groups in terms of the mean operation time for ERM–inner limiting membrane peeling (27G vs 25G: 20.2±9.9 vs 16.1±9.3 min, P=0.14), although the time for vitreous cutting was longer in the 27G group (9.9±3.5 vs 6.2±2.7 min, respectively, P<0.0001). The flare value, intraocular pressure (IOP), and rate of hypotony 1 day after surgery did not differ between the 27G and 25G groups (flare value: 18.7 vs 17.2; IOP: 8.8 vs 9.7 mm Hg; rate of hypotony: 30 vs 35%, respectively). There was no significant difference in the surgically induced astigmatism between the two groups in the follow-up period. The mean time required for wound closure did not show a significant difference between the 27G and 25G groups (7.7 vs 8.6 weeks, respectively).ConclusionThe 27G system is as safe and useful for ERM vitrectomy as the 25G system. Based on its potential, further improvement of 27G instruments could result in greater efficiency.

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Time Course of Changes in Aqueous Flare Intensity After Vitrectomy for Rhegmatogenous Retinal Detachment

Abstract: Aqueous flare intensity after vitrectomy for RD decreased to a stable level at 3 months postoperatively but remained significantly higher than the normal level. The size of retinal breaks and the degree of surgical invasion were associated with the increase in aqueous flare.

Cited by 20 publications

References 33 publications

Management of postoperative inflammation after cataract and complex ocular surgeries: a systematic review and Delphi survey

Management of postoperative inflammation after cataract and complex ocular surgeries: a systematic review and Delphi survey

Anterior chamber aqueous flare and optic nerve microcirculation in eyes with rhegmatogenous retinal detachment

Comparative study of 27-gauge vs 25-gauge vitrectomy for epiretinal membrane

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