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Changes in Intraocular Pressure in Single Ventricle Patients After the Glenn or Fontan Procedure
Riki Kijima1, Osamu Sasaki2, Yasuhiro Shinmei1
1Departments of Ophthalmology.
Insights
Intraocular pressure (IOP) correlates with central venous pressure (CVP) in single ventricle (SV) patients undergoing cardiac surgery. Postoperative monitoring of IOP is crucial after Glenn and Fontan procedures due to elevated CVP.
Area of Science:
- Cardiology
- Ophthalmology
- Pediatric Surgery
Background:
- Single ventricle (SV) is a complex congenital heart defect requiring staged surgical palliation.
- The Glenn and Fontan procedures significantly alter central venous pressure (CVP).
- Intraocular pressure (IOP) variability may be linked to CVP fluctuations.
Purpose of the Study:
- To investigate the relationship between CVP and IOP in patients with SV.
- To assess IOP and CVP changes perioperatively after Glenn and Fontan procedures.
Main Methods:
- Prospective, nonrandomized case series.
- Inclusion of 14 patients with SV undergoing Glenn or Fontan procedures.
- Concurrent monitoring of IOP and CVP before and after surgery.
Main Results:
- A positive correlation was found between CVP and IOP in the perioperative period.
- Both IOP and CVP were significantly elevated postoperatively compared to preoperatively.
- No direct relationship was observed between the *changes* in IOP and CVP after surgery.
Conclusions:
- Elevated CVP is associated with increased IOP in SV patients post-Glenn/Fontan.
- Close IOP monitoring is essential in the postoperative care of SV patients.
Abstract:
PRéCIS:: A positive correlation was observed between intraocular pressure (IOP) and central venous pressure (CVP) in patients with single ventricle (SV) during the perioperative period. IOP needs to be carefully monitored in the postoperative period after the Glenn and Fontan procedures, particularly the Glenn procedure.
Purpose:
SV is a cardiac malformation characterized by the existence of only 1 functional ventricle and is treated using the Glenn and Fontan procedures. Significant changes occur in CVP after these procedures. IOP has been reported to differ in the same individual when measured in a seated or supine position, which may be related to CVP. In the present study, we examined the relationship between CVP and IOP before and after surgery for SV.
Patients And Methods:
This study was a prospective, nonrandomized case series. All patients had SV and this study excluded those with eye diseases associated with ocular hypertension. We measured IOP before and after the Glenn or Fontan procedure. CVP was concurrently monitored.
Results:
Twenty-eight eyes of 14 patients with SV who underwent the Glenn (N=8) or Fontan (N=6) procedure were examined. Mean ages (±SD) were 2.6±0.7 months for the Glenn procedure and 24.0±2.7 months for the Fontan procedure. A correlation was observed between CVP and IOP in the perioperative period. IOP and CVP were both significantly higher after than before the Glenn and/or Fontan procedures. However, no relationship was noted between changes in IOP and CVP after the Glenn and/or Fontan procedures.
Conclusions:
Elevations in CVP significantly increased IOP in patients with SV who underwent the Glenn or Fontan procedure. IOP needs to be carefully monitored in the postoperative period after both procedures.
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