Early rapid rise in intraocular pressure after intravitreal triamcinolone acetonide injection (original) (raw)
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Ophthalmic surgery, lasers & imaging retina, 2015
To investigate cases of retained intraocular perfluoro-n-octane (PFO) after pars plana vitrectomy (PPV) for retinal detachment (RD). Retrospective, noncomparative case series of six eyes with retained intraocular PFO after RD repair. Clinical data were supplemented with an experimental silicone eye model. A cluster of six cases of retained intraocular PFO after PPV for RD repair were noted shortly after transitioning to valved cannulas. PFO was noted in the anterior chamber (AC) and/or vitreous and removed with AC paracentesis, AC wash-out, and/or PPV. A silicone eye model demonstrated that PFO levels are maintained anterior to cannula insertion with valved cannulas only. The authors hypothesize that anterior PFO fill using valved cannulas can lead to sequestration within the AC, zonules, ciliary sulcus, ciliary teeth, and/or capsular bag. They suggest vigilance in not overfilling PFO, particularly when transitioning to use of valved cannulas, to minimize the risk of intraocular ret...
Middle East African Journal of Ophthalmology, 2014
In this case report, we present a 35-year-old patient with retained PFO up to 9 years after par plana vitrectomy. Post-operatively, PFO bubbles occupied 15% of the anterior chamber (AC). Follow-up over 9 years, consistently showed a quiet AC, normal intraocular pressure and endothelial cell counts remained stable. Until date, the patient has been under observation and there have been no ocular symptoms or side-effects. Residual PFO that inadvertently remains in the AC can be well-tolerated, without side-effects for up to 9 years.
Case Reports in Ophthalmological Medicine
Purpose. To report unprompted closure of spontaneous macular hole secondary to inadvertent subfoveal perfluorocarbon liquid (PFCL) after vitrectomy surgery. Observations. We present a case of a retained large single subfoveal PFCL droplet following vitrectomy and silicone oil injection for subtotal rhegmatogenous retinal detachment that showed spontaneous release 3 weeks postoperatively, with subsequent development of full thickness macular hole (FTMH) which completely closed later on after silicone oil removal without internal limiting membrane peeling with marvelous anatomic and visual improvement after spontaneous closure of MH. Conclusions. Different fates of subfoveal PFCL droplets may happen. Spontaneous release of subfoveal PFCL without surgical interference has rarely been reported.
Retinal Hole as a Complication of Long-Standing Subretinal Perfluorocarbon Liquid
Retina, 2006
A 59-year-old man was referred to our institution for fluorescein angiography and optical coherence tomography of the left eye. Six years previously, this eye had been operated on for complex retinal detachment. Perfluorocarbon liquid (PFC; Perfluoron, Alcon Laboratories, Inc., Forth Worth, TX) and silicone tamponade were used intraoperatively. The silicone was removed 6 months later, and the retina remained flat. Visual acuity in the left eye was 20/40 after cataract surgery. However, a subretinal bleb was observed in the upper temporal macula, as a result of intraoperative migration of PFC into the subretinal space. Recently, a retinal hole was noted in the upper part of the bleb (Fig. 1). Fluorescein angiography showed that the area occupied by PFC was hyperfluorescent, with a window defect (Fig. 2). Optical coherence tomography revealed a prominent oval subretinal bleb (Fig. 3). Scans passing through the hole disclosed a full-thickness retinal hole (Fig. 4).
Suprachoroidal Gas: A Rare Complication of Intravitreal Injection of Perfluoropropane
Case Reports in Ophthalmology, 2021
This is a case report of a 75-year-old pseudophakic male, who presented with a massive submacular hemorrhage on a background of neovascular age-related macular degeneration. Intravitreal perfluoropropane was used to attempt pneumatic displacement of the submacular hemorrhage. The next day, subconjunctival gas was observed, with no gas seen in the vitreous cavity. Fundal examination showed suprachoroidal detachment. CT images confirmed gas entrapment, with no choroidal hemorrhage identified. The following case report describes suprachoroidal gas as a complication of intravitreal injection of perfluoropropane for pneumatic displacement of submacular hemorrhage. To our knowledge, this is the first such case in the literature. We describe the approach in differentiating suprachoroidal gas from hemorrhage and comment on a plausible mechanism for this complication. This report also serves as a review of the current state of knowledge in the area of suprachoroidal gas as a complication of ...
Perfluorocarbon liquids in ophthalmology
Survey of Ophthalmology, 1995
Perfluorocarbon liquids have been used to facilitate surgery in a wide variety of conditions, including proliferative vitreoretinopathy, giant retinal tears, drainage of suprachoroidal hemorrhages, diabetic traction, retinal detachments with a rhegmatogenous component, dislocated crystalline or intraocular lenses, and retinal detachment associated with choroidal coloboma. The clarity of perfluorocarbon liquids, with a refractive index close to that of water, allows the use of a conventional contact lens for vitreous surgery while the low viscosity facilitates tissue manipulation, injection, and removal. All perfluorocarbon liquids when used as tamponading agents can compress and disorganize the retina. This "toxicity" is a physical effect rather than chemical toxicity and depends upon the amount of perfluorocarbon liquid injected. Perfluorocarbon liquids are not tolerated in the anterior chamber, causing corneal edema within 2-3 days at the site of contact. (Surv Ophthalmol 39: 1995) Key words, perfluorocarbon liquids 9 retinal detachment ~ vitreous substitutes
Foreign Body Response Within Postoperative Perfluoro-N-Octane for Retinal Detachment Repair
Retina-the Journal of Retinal and Vitreous Diseases, 2014
Purpose: To describe the clinical and histopathologic characteristics of inflammatory deposits occurring within intermediate duration postoperative perfluoro-n-octane (PFO) for inferior retinal detachment repair. Methods: Prospective interventional case series of consecutive patients with inferior retinal detachment treated with intermediate duration postoperative vitreous cavity PFO endotamponade were analyzed by ophthalmoscopy for the presence of inflammation and white deposits. Ten consecutive samples developing white deposits were analyzed microscopically. Clinical variables were analyzed. Results: One hundred and eighty-one eyes of 181 patients were included (mean age = 52.4 ± 14 years; mean follow-up = 29.7 ± 14 months). Fifty of 181 patients (28%) developed a characteristic foreign body response with abundant white deposits within indwelling PFO. Ten consecutive samples analyzed histologically contained abundant macrophages, the absence of additional inflammatory cells, and intracytoplasmic optically lucent inclusions. Foreign body response was associated with longer duration of PFO (P = 0.003). Perfluoron-octane foreign body response was not associated with age (P = 0.136), ethnicity (P = 0.101), visual outcome (P = 0.157), or persistent intraocular pressure elevation (P = 0.381). Conclusion: A stereotypical foreign body response occurs in 30% of patients with postoperative vitreous cavity PFO and becomes clinically apparent at 7 days to 10 days after initial placement for rhegmatogenous retinal detachment repair. The response consists almost exclusively of macrophages and does not seem to be related to either long-term intraocular pressure elevation or visual outcome. The response may be related to the duration of indwelling PFO and may limit visualization of the retina during PFO removal.
Acta Clinica Croatica, 2018
-Th e aim was to compare the effi cacy of a single intravitreal injection of perfl uoropropane (C3F8) and sulfur hexafl uoride (SF6) in releasing vitreomacular traction (VMT). Th is prospective study included two groups of patients with symptomatic VMT confi rmed by spectral-domain optical coherence tomography (SD-OCT). Patients from both groups received a single intravitreal injection of expansile gas. One group (29 eyes) received 0.3 mL of 100% C3F8, and the other group (28 eyes) received 0.3 mL of 100% SF6. Eyes without VMT release one month after SF6 injection were secondarily injected with C3F8. Th e primary outcome was the ratio of eyes in each group with complete VMT release on OCT one month following primary treatment. Th e secondary outcome was the ratio of reinjected eyes with complete VMT release on OCT one month following second injection. Additional outcome was the ratio of VMT release in eyes with specifi c clinical characteristics. One month after the application, complete release of VMT on OCT was recorded in 18 out of 29 eyes (62%) in the C3F8 group, in 6 out of 28 eyes (21.4%) in the SF6 group, and in 7 out of 14 (50%) reinjected eyes. Th ere was no statistically signifi cant diff erence in age, width of vitreomacular attachment (WVMAT), central retinal thickness and presence of additional features between the two groups. In eyes with WVMAT <500 microns, there was no statistically signifi cant diff erence between the two gases in releasing VMT. In eyes with WVMAT >500 microns, C3F8 was more effi cacious (p=0.001). According to the results of our study, intravitreal C3F8 injection seems to be more effi cacious in releasing VMT than SF6 in eyes with WVMAT larger than 500 microns.