A Novel Surgical Method to Treat Hypotony


ABSTRACT

Introduction:

The treatment of ocular hypotonia depends on the underlying problem. No clinically useful medications are available that raise intraocular pressure (IOP).The anterior chamber may be filled with viscoelastic or a pars plana injection of viscoelastic, gas or silicone oil as a temporary solution. In cases of chronic ocular hypotony , an effective and permanent treatment method is needed.

Aim:

To assess the effect of a novel surgical method in the treatment of chronic ocular hypotony. Surgical method aims blocking iridocorneal angle partially and decrease aqueous humor outflow. A capsular tension ring is placed to the iridocorneal angle for this aim.

Methods:

Thirteen eyes of 13 patients were included in this retrospective study. All eyes had severe ocular hypotony with the diagnosis of hypotony after vitreoretinal surgery or glaucoma filtration surgery. Capsular tension ring(CTR) was placed to the iridocorneal angle though a corneal incision. Follow-up period was at least one year. The patients were divided into three groups: group 1 severe hypotonic eyes without silicone oil endotamponade (IOP less than 6 mmHg), group 2 severe hypotonic eyes with silicone oil endotamponade(IOP less than 6 mmHg), and group 3 mild hypotonic eyes with silicone oil endotamponade(IOP equal or more than 6 mmHg). Group 3 eyes were also severe hypotony eyes and were previously filled with silicone oil tamponade in order to treat COH. This group is included in the study in order to to see if silicone oil removal will be possible after CTR implantation to the iridocorneal angle.

Results:

Intraocular pressure (IOP) increased in all eyes. IOP rise remained during follow-up. Visual acuity increased or stabilized in all eyes. No ocular complication was noted due-to procedure.

Conclusion:

We described a novel and simple technique for the setting of IOP in chronic hypotony. Mechanical obstruction of aqueous humor outflow with capsular tension ring can increase IOP and stabilize or improve vision in eyes with chronic ocular hypotony for a follow up time longer 12 months.


CONTACT DETAILS

 

Gokhan Gurelik
Ankara, Turkey
Email : gurelik@rocketmail.com
Cell Phone: +905323267378
Work Phone: +903122026330