Chronic hypotony management using endoscopy-assisted vitrectomy after severe ocular trauma or vitrectomy

Area of Science:

• Ophthalmology
• Surgical Innovation

Background:

• Chronic hypotony following severe ocular trauma or vitrectomy presents a significant management challenge.
• Restoring intraocular pressure (IOP) is crucial for preserving visual function and preventing phthisis bulbi.

Purpose of the Study:

• To evaluate the outcomes of endoscopy-assisted vitrectomy (EAV) in patients with chronic hypotony.
• To assess the efficacy of EAV in improving IOP and best-corrected visual acuity (BCVA).

Main Methods:

• A retrospective, noncomparative case series involving seven patients with chronic hypotony.
• Endoscopy-assisted vitrectomy (EAV) with ciliary body membrane removal, gas/silicone oil tamponade, and scleral buckling in select cases.
• Pre- and post-operative IOP and BCVA measurements were the primary outcome metrics.

Main Results:

• Mean pre-operative IOP of 4.5 mm Hg increased to 9.9 mm Hg at 12 months post-EAV.
• BCVA improved in six out of seven eyes; no cases of phthisis bulbi were observed.
• Surgical interventions included gas/silicone oil tamponade and scleral buckling in various combinations.

Conclusions:

• Endoscopy-assisted vitrectomy (EAV) provides enhanced visualization and judgment during surgery for chronic hypotony.
• EAV is an effective and promising surgical technique for managing chronic hypotony, improving IOP and visual outcomes.