ABSTRACT

Objective:

To explore the effects of various procedures in the treatment of intractable hypotony and atrophic eyes.

Methods:

According to the cause and the signs (esp. the IOP and the axial length) of the eyes, the following procedures were performed (alone or combined): injection of large amount of viscoelastics, trabecular meshwork photocoagulation (TMP), vitrectomy combined with photocoagulation of exposed retinal pigment epithelium (RPE) and ciliary membrane peeling assited by endoscopes. To those severely atrophied eyes (as short as 17mm in axial length and as long as 1 year of hypotony) with little space to do vitrectomy, expanding gas injection pre-vitrectomy and/or continuous intraocular injection of silicone oil combined after vitrectomy were performed. The axial length, the volume of the eyes (by CT scan), the intraocular pressure (IOP) and the visual acuity, etc. were measured, compared and analyzed before and after the procedures. The patients were followed for 3 months to 12 years.

Results:

Injection of large amount of viscoelastics, trabecular meshwork photocoagulation (TMP), vitrectomy combined with photocoagulation of exposed retinal pigment epithelium (RPE) decreased the out-flow of the aqueous humorous and prevented hypotony. Ciliary membrane peeling assited by endoscopes improved the secretion of the aqueous humorous and increased the IOP. Expanding gas injection pre-vitrectomy and/or continuous intraocular injection of silicone oil combined with vitrectomy expaned the shrinked eyes, provide the room for vitrectomy and reconstructed the intraocular physical circulation and increased the IOP. All axial length of atrophic eyes are extended after vitrectomy combined with continuous intraocular injection of silicone oil ,the IOP of more than 80% hypotony eyes are increased after TMP, etc. Redetached retina, hypotony and band degeneration of the cornea were the main complications.

Conclusions:

These procedures can effectively restore the eye shape, restore the intraocular pressure, assist retina/choroid reattachment, maintain or improve the visual activity and provide opportunity for removal of silicon oil despite of large area of retinal defect. Enucleation can be prevented in most severely traumatized eyes or the eyes after multiple unsuccessful intraocular surgeries.


CONTACT DETAILS

 

Xun YANG*, Shu DU, Youyou ZHA
Lixiang Eye Hospital of Soochow University
Su zhou
China
Email : dryangxun@163.com
Cell Phone: +8613982128299
Work Phone: +8613982128299