Treating uveitis-associated hypotony with pars plana vitrectomy and silicone oil injection.
OBJECTIVE
The purpose of this study was to determine the effect on intraocular pressure (IOP) and visual acuity of treating uveitis-related hypotony in patients with vitrectomy and intravitreal silicone oil injection.


METHODS
Patients who underwent pars plana vitrectomy and silicone oil injection for uveitis-associated hypotony treatment were identified retrospectively. The primary outcome was maintaining an IOP of > or =5 mmHg. Visual acuity improvement was defined as an increase in > or =2 lines of acuity.


RESULTS
Twelve eyes of 10 patients were identified. Median preoperative IOP was 2 mmHg (range: 0-7 mmHg). Two of 12 eyes had an IOP of > or =5 mmHg at presentation. The number of eyes with an IOP of > or =5 mmHg was 7 of 12 eyes (58%) at 1 month, 4 of 12 eyes (33%) at 3 months, 6 of 12 eyes (50%) at 6 months, and 3 of 9 eyes (33%) at 1 year. Five of 12 eyes (42%) were reinjected between 1 and 3 times with silicone oil for recurring hypotony. Median presenting Snellen visual acuity was counting fingers (range: 20/125 to light perception). Seven of 9 eyes (78%) maintained their preoperative vision at 1 year.


CONCLUSIONS
Intraocular pressure elevated modestly in most patients in this series. However, results were often transient, and some eyes required repeated silicone oil injections. Although silicone oil is reasonable to consider for the treatment and maintenance of IOP in patients with ocular hypotony secondary to uveitis, better treatments are needed.
Kapur
Rashmi
R
Department of Ophthalmology and Visual Sciences, University of Illinois, Chicago, Illinois, USA.
Birnbaum
Andrea D
AD
Goldstein
Debra A
DA
Tessler
Howard H
HH
Shapiro
Michael J
MJ
Ulanski
Lawrence J
LJ
Blair
Michael P
MP
D000293:Adolescent; D000328:Adult; D002648:Child; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007267:Injections; D007429:Intraocular Pressure / Q000502:physiology; D008297:Male; D008875:Middle Aged; D015814:Ocular Hypotension / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D012008:Recurrence; D019233:Retreatment; D012189:Retrospective Studies; D012827:Silicone Oils / Q000008:administration & dosage*; D014605:Uveitis / Q000150:complications / Q000503:physiopathology / Q000628:therapy*; D014792:Visual Acuity / Q000502:physiology; D014821:Vitrectomy
D012827:Silicone Oils