title: Pars plana vitrectomy, fluocinolone acetonide implantation, and silicone oil infusion for the treatment of chronic, refractory uveitic hypotony.
abstract: OBJECTIVE
  To assess the feasibility and outcomes of combining fluocinolone acetonide sustained drug delivery implant insertion, pars plana vitrectomy, and silicone oil infusion to treat patients with chronic, refractory ocular hypotony resulting from uveitis.
  
  
  METHODS
  Retrospective chart review.
  
  
  METHODS
  A retrospective, institutional chart review was performed. Outcome measures included visual acuity, intraocular pressure, and adverse events.
  
  
  RESULTS
  A total of 13 eyes of 11 patients were studied. All patients were women, had a mean age of 57 years (range, 26 to 73 years), and had a diagnosis of panuveitis. The mean duration of preoperative hypotony was 42 months (range, 11 to 108 months). Patients were followed up on average for 22 months (range, 9 to 46 months) after the combined surgical procedure. The mean preoperative visual acuity was 20/1000 (logarithm of the minimal angle of resolution, 1.7). At the 6- and 12-month visits, the mean visual acuity remained stable at 20/800 (logarithm of the minimal angle of resolution, 1.6; P = .74) and 20/600 (P = .34), respectively. At baseline, the mean intraocular pressure (IOP) was 2.3 mm Hg. The average IOP was 5.9 mm Hg, 5.1 mm Hg, and 5.0 mm Hg at 6, 12, and 24 months after surgery, respectively. The increase in IOP relative to the baseline IOP was statistically significant at 6 and 12 months (P = .027 and P = .004, respectively). The duration of preoperative hypotony inversely correlated with the IOP at 6 months (P = .027). No intraoperative complications were encountered and the procedure was well tolerated.
  
  
  CONCLUSIONS
  Fluocinolone acetonide implantation combined with pars plana vitrectomy and silicone oil infusion is feasible and is well tolerated in the management of chronic, refractory ocular hypotony associated with uveitis.
authors.affiliation: Department of Ophthalmology, Duke University Eye Center, Durham, North Carolina 27710, USA.
authors.forename: Pouya N
authors.initials: PN
authors.lastname: Dayani
authors.forename: Jessica
authors.initials: J
authors.lastname: Chow
authors.forename: Sandra S
authors.initials: SS
authors.lastname: Stinnett
authors.forename: Glenn J
authors.initials: GJ
authors.lastname: Jaffe
mesh_terms: D000328:Adult; D000368:Aged; D002908:Chronic Disease; D003131:Combined Modality Therapy; D004343:Drug Implants; D005260:Female; D005446:Fluocinolone Acetonide / Q000008:administration & dosage*; D005500:Follow-Up Studies; D005938:Glucocorticoids / Q000008:administration & dosage*; D006801:Humans; D007429:Intraocular Pressure / Q000502:physiology; D008875:Middle Aged; D015814:Ocular Hypotension / Q000188:drug therapy / Q000209:etiology / Q000601:surgery / Q000628:therapy*; D012008:Recurrence; D012189:Retrospective Studies; D012827:Silicone Oils / Q000008:administration & dosage*; D014065:Tonometry, Ocular; D014605:Uveitis / Q000150:complications / Q000188:drug therapy / Q000601:surgery / Q000628:therapy*; D014792:Visual Acuity / Q000502:physiology; D014821:Vitrectomy; D014822:Vitreous Body
chemical_list: D004343:Drug Implants; D005938:Glucocorticoids; D012827:Silicone Oils; D005446:Fluocinolone Acetonide