Journals / Retina-Vitreus / 2017 / Cilt: 26 - Sayı: 0

Surgical Approaches in Chronic Ocular Hypotony

Kronik Oküler Hipotonide Cerrahi Tedavi Yaklaşımları

Pages
166–173
DOI
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AI Summary & Key Takeaways

AI Insight
⚡ TL;DR(Too Long; Didn't Read)

Ciliary body transplantation or vertricolo- vitreal (cerebrovitreal) shunt applications may be future treatment options for protec- ting these eyes from development of phytisis bulbi.

📌 3 Key Takeaways

🎯
Objective & Hypothesis:Diagnosis, etiopathogenesis and especially surgical treatment options of chronic ocular hypotony are discussed in this review.
📊
Key Findings & Data:Two main mechanisms of chronic hypotony are increased aqueo- us outfl ow and reduced aqueous production.
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Conclusion & Impact:Ciliary body transplantation or vertricolo- vitreal (cerebrovitreal) shunt applications may be future treatment options for protec- ting these eyes from development of phytisis bulbi.
🔬Design:Review & Systematic Survey
📍Scope:Comprehensive Sample
⚙️Variables:Domain Parameters

Abstract

Diagnosis, etiopathogenesis and especially surgical treatment options of chronic ocular hypotony are discussed in this review. Two main mechanisms of chronic hypotony are increased aqueo- us outfl ow and reduced aqueous production. While increased filt- ration can be eff ectively treated by surgery in most cases, there is no eff ective and longstanding therapy for ciliary body dysfun- ction. Dissection and removal of cyclic membranes and relief of traction on the ciliary body provide a moderate increase in int- raocular pressure. Occlusion of aqueous outfl ow via implanting a capsular tension ring to the iridocorneal angle off ers eff ective increase in intraocular pressure in patients having some healt- hy ciliary tissue. However, in eyes with no or minimal aqueous production, blockage of the iridocorneal angle would not work. Ciliary body transplantation or vertricolo- vitreal (cerebrovitreal) shunt applications may be future treatment options for protec- ting these eyes from development of phytisis bulbi.

Özet

Bu derlemede kronik oküler hipotoninin tanı, etyopatogenezi ve cerrahi başta olmak üzere tedavi seçenekleri tartışılmıştır. Hipo- toninin iki temel nedeni; artmış aköz hümör dışa akımı ve azal- mış aköz hümör üretimidir. Aşırı filtrasyon çoğu vakada cerrahi olarak iyi tedavi edilebilebirken, siliyer disfonksiyonunun etkin ve kalıcı bir tadavisi yoktur. Siklitik membranların temizliği ve traksiyonların rahatlatılması göz içi basıncında orta düzeyde bir artış sağlamaktadır. Bir miktar aköz salınımının olduğu durum- larda dışa akım yolunun kapsül germe halkası ile blokajı hipo- toniyi tedavi etmede etkin bulunmuştur. Fakat, aköz hümör sa- lınımının olmadığı gözlerde bu blokaj başarısız olacaktır. Siliyer doku transplantasyonu veya ventrikülo-vitreal (serebrovitreal) şant uygulamaları bu gözlerde fitizis bulbi gelişimini önlemede umut vadeden tedavi yöntemleri olabilir.

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Cite This Article

GÜRELİK, G., KORKMAZ, Ş. (2017). Surgical Approaches in Chronic Ocular Hypotony. Retina-Vitreus, Cilt: 26 - Sayı: 0, 166–173. https://ajindex.com/articles/304926

References (12)

  1. Johnstone MA. Hypotony: what is it? How should we manage it? J Glaucoma 2000;9:131-133.
  2. Fine HF, Biscette O, Chang S, Schiff WM. Ocular hypotony: a review. Comp Ophthalmol Update 2007;8:29-37.
  3. Kim HC, Hayashi A, Shalash A, de Juan E Jr.A model of chro- nic hypotony in the rabbit.Graefes Arch Clin Exp Ophthalmol. 1998;236:69-74. Schubert HD. Postsurgical hypotony: relationship to fistulizati- on, infl ammation, chorioretinal lesions, and the vitreous. Surv Ophthalmol. 1996;41:97-125. Pederson JE. Ocular hypotony. Trans Ophthalmol Soc UK 1986;105:220-226.
  4. Toris CB, Pederson JE. Aqueous humor dynamic in experiman- tal iridocyclitis. Invest Ophthalmol Vis Sci. 1987;28:477-481.
  5. Coleman, D.J. Evaluation of ciliary body detachment in hypo- tony. Retina 1995;15: 312-318. Gonvers M. Temporary silicone oil tamponade in the manage- ment of retinal detachment with ploriferative vitreoretinopathy. Am J Ophthalmol. 1985;100:239-245.
  6. Quiram PA, Gonzales CR, Hu W, Gupta A, Yoshizumi MO, Kre- iger AE, Schwartz SD. Outcomes of vitrectomy with inferior re- tinectomy in patients with recurrent rhegmatogenous retinal detachments and proliferative vitreoretinopathy. Ophthalmo- logy. 2006;113:2041-7
  7. Grigoropoulos VG, Benson S, Bunce C, Charteris DG. Func- tional outcome and prognostic factors in 304 eyes managed by retinectomy. Graefes Arch Clin Exp Ophthalmol. 2007;245:641-9
  8. Lee GD, Goldberg RA, Heier JS. Endoscopy-assisted vitrectomy and membrane dissection of anterior proliferative vitreoretino- pathy for chronic hypotony after previous retinal detachment re- pair. Retina. 2016;36:1058-1063.
  9. Arevalo JF, Garcia RA, Fernandez JF. Anterior segment infl am- mation and Hypotony after posterior segment surgery. Ophthal- mol Clin North Am. 2004;17:527-537.
  10. Jonas JB, Kreissig I & Degenring R. Intraocular pressure after intravitreal injection of triamcinolone acetonide. Br J Ophthal- mol 2003;87: 24-27.
  11. Jonas JB, Vossmerbaeumer U, Kamppeter BA. Chronic prep- hthisical ocular hypotony treated by intravitreal triamcinolone acetonide.Acta Ophthalmol Scand. 2004;82:637. Jonas JB, Hayler JK, Panda-Jonas S. Intravitreal injection of crystalline cortisone as treatment of pre-phthisical ocular hypo- tony. Graefes Arch Clin Exp Ophthalmol. 2001;239:464-5
  12. Ganteris-Gerritsen E, Ugahary LC, Jansen J, Mulder PG, Co- hen AF, van Meurs JC. Six months treatment with ibopamine in patients with hypotony after vitreoretinal surgery for retinal de- tachment, uveitis or penetrating trauma.Retina. 2012;32: