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Intraocular pressure fluctuations during scleral buckling surgery
T W Gardner1, D A Quillen, G W Blankenship
1Department of Ophthalmology, Penn State University College of Medicine, Hershey 17033.
Ophthalmology
|July 1, 1993
Summary
Scleral buckling surgery causes significant intraocular pressure (IOP) spikes, potentially impairing ocular perfusion. These elevated pressures, particularly during globe manipulation, may compromise retinal artery blood flow.
Area of Science:
- Ophthalmology
- Surgical Innovation
- Retinal Surgery
Background:
- Scleral buckling is a common surgical technique for retinal detachment.
- Intraocular pressure (IOP) dynamics during this procedure are not well-characterized.
- Understanding IOP fluctuations is crucial for preventing ocular complications.
Purpose of the Study:
- To measure real-time intraocular pressure (IOP) during scleral buckling surgery.
- To assess the impact of elevated IOP on ocular perfusion, specifically central retinal artery closure.
- To identify surgical maneuvers associated with significant IOP changes.
Main Methods:
- Real-time IOP was measured in 20 eyes undergoing scleral buckling using a pars plana infusion cannula and hemodynamic monitoring.
- The IOP required to occlude the central retinal artery was determined.
- Pressure data were recorded intraoperatively and postoperatively.
Main Results:
- Intraocular pressure (IOP) elevations reached up to 210 mmHg during scleral depression and cryopexy.
- Central retinal artery closure occurred at pressures between 48-110 mmHg (mean 79.2 mmHg).
- Elevated IOP exceeding central retinal artery perfusion pressure was observed in 13 of 20 patients, lasting up to 402 seconds.
Conclusions:
- Conventional scleral buckling surgery leads to significant IOP fluctuations.
- These pressure changes may compromise ocular perfusion and retinal blood flow.
- Further research is needed to evaluate the long-term effects of these IOP elevations.