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      Comparison of Methods of Endotamponade Used During 23-Gauge Pars Plana Vitrectomy and the Risk of Raised Intraocular Pressure During 24-Month Follow-Up: A Retrospective Study of 196 Patients

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          Abstract

          Background

          Pars plana vitrectomy (PPV) is used to treat retinal conditions, including retinal detachment, and involves removal of the vitreous gel from the eye. Complications following PPV include raised intraocular pressure (IOP). This retrospective study aimed to compare methods of endotamponade used during 23-gauge PPV and the risk of raised IOP during 24-month follow-up at a single center.

          Material/Methods

          The study included 196 patients (age, 15–86 years; mean, 63.5 years) (196 eyeballs). There were 93 patients (47.45%) with a preoperative history of type 2 diabetes mellitus and 14 patients (7.14%) with a history of myopia. IOP was measured with Goldmann applanation tonometry at one-, three-, six-, 12-, and 24-month follow-up. The outcome was compared following endotamponade with silicone oil, sulfur hexafluoride (SF6), and balanced salt solution (BSS).

          Results

          Mean IOP at one-month follow-up was 17.2 mmHg (±3.61 mmHg; range, 9–45 mmHg), and at 24-month follow-up was 17.3 mmHg (±3.23 mmHg; range, 7–30 mmHg). IOP following PPV was significantly associated with the indication for PPV (P=0.023), and the type of endotamponade used (P=0.049). In patients with silicone oil endotamponade, the risk of IOP at 24 months was increased by 2.3 times compared with SF6 or BSS endotamponade. Patients with SF6 endotamponade had a risk of IOP that was 3.3 times lower than for silicone oil tamponade or BSS tamponade.

          Conclusions

          Silicone oil endotamponade in PPV was associated with an increased risk of IOP at 24-month follow-up.

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          Most cited references30

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          Global variations and time trends in the prevalence of primary open angle glaucoma (POAG): a systematic review and meta-analysis

          Systematic review of published population based surveys to examine the relationship between primary open angle glaucoma (POAG) prevalence and demographic factors. A literature search identified population-based studies with quantitative estimates of POAG prevalence (to October 2014). Multilevel binomial logistic regression of log-odds of POAG was used to examine the effect of age and gender among populations of different geographical and ethnic origins, adjusting for study design factors. Eighty-one studies were included (37 countries, 216 214 participants, 5266 POAG cases). Black populations showed highest POAG prevalence, with 5.2% (95% credible interval (CrI) 3.7%, 7.2%) at 60 years, rising to 12.2% (95% CrI 8.9% to 16.6%) at 80 years. Increase in POAG prevalence per decade of age was greatest among Hispanics (2.31, 95% CrI 2.12, 2.52) and White populations (1.99, 95% CrI 1.86, 2.12), and lowest in East and South Asians (1.48, 95% CrI 1.39, 1.57; 1.56, 95% CrI 1.31, 1.88, respectively). Men were more likely to have POAG than women (1.30, 95% CrI 1.22, 1.41). Older studies had lower POAG prevalence, which was related to the inclusion of intraocular pressure in the glaucoma definition. Studies with visual field data on all participants had a higher POAG prevalence than those with visual field data on a subset. Globally 57.5 million people (95% CI 46.4 to 73.1 million) were affected by POAG in 2015, rising to 65.5 million (95% CrI 52.8, 83.2 million) by 2020. This systematic review provides the most precise estimates of POAG prevalence and shows omitting routine visual field assessment in population surveys may have affected case ascertainment. Our findings will be useful to future studies and healthcare planning.
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            LXII Edward Jackson lecture: open angle glaucoma after vitrectomy.

            To present data and an hypothesis for the late development of open angle glaucoma (OAG) after vitrectomy.
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              Diabetes, intraocular pressure, and primary open-angle glaucoma in the Baltimore Eye Survey.

              The association of diabetes with primary-open angle glaucoma (POAG) has been controversial and often confused by varying definitions of both diabetes and POAG. The purpose of this study is to evaluate this association in a population-based sample of subjects from the Baltimore Eye Survey. A stratified sample of residents in 16 cluster areas of east Baltimore was recruited for a detailed ophthalmologic screening examination. A total of 5308 black subjects and white subjects participated. Of these participants, 161 received a diagnosis of POAG. During a detailed interview with each subject, diabetes was defined based on a reported history of diabetes. Persons with diabetes were classified as "insulin-users" and "noninsulin-users" based on their current method of treatment. Diabetes was highly prevalent in this population, with 10.6% of white subjects and 17.2% of black subjects reporting a positive history. Diabetes was associated with higher intraocular pressure, but differences were not large (means, 17.4, 18.0, and 17.8 mmHg) among subjects without diabetes, those with diabetes who were not using insulin, and those with diabetes who were using insulin, respectively. Diabetes was not associated with POAG (age-race-adjusted odds ratio, 1.03; 95% confidence interval, 0.85, 1.25). This was true for both types of diabetes. Persons whose POAG had been diagnosed before the examination showed a positive association with diabetes (odds ratio, 1.7, 95% confidence interval, 1.03, 2.86), indicating that selection bias could explain the positive results of previous clinic-based investigations. There is no evidence from this population-based investigation that supports an association between diabetes and POAG.
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                Author and article information

                Journal
                Med Sci Monit
                Med. Sci. Monit
                Medical Science Monitor
                Medical Science Monitor : International Medical Journal of Experimental and Clinical Research
                International Scientific Literature, Inc.
                1234-1010
                1643-3750
                2019
                07 December 2019
                : 25
                : 9327-9334
                Affiliations
                [1 ]Department of Ophthalmology with Pediatric Unit, St. Barbara Hospital Trauma Center, Sosnowiec, Poland
                [2 ]Clinical Department of Ophthalmology, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia, Katowice, Poland
                [3 ]Katowice School of Technology, The University of Science and Art in Katowice, Katowice, Poland
                [4 ]Center of Oncology, M. Sklodowska-Curie Memorial Institute, Cracow Branch, Cracow, Poland
                [5 ]Department of Molecular Biology, School of Pharmacy with the Division of Laboratory Medicine in Sosnowiec, Medical University of Silesia in Katowice, Katowice, Poland
                Author notes
                Corresponding Author: Anita Lyssek-Boroń, e-mail: anitaboron3@ 123456gmail.com
                [A]

                Study Design

                [B]

                Data Collection

                [C]

                Statistical Analysis

                [D]

                Data Interpretation

                [E]

                Manuscript Preparation

                [F]

                Literature Search

                [G]

                Funds Collection

                Article
                918114
                10.12659/MSM.918114
                6916133
                31811816
                a6315369-c9a9-4197-976b-5603517e01a4
                © Med Sci Monit, 2019

                This work is licensed under Creative Common Attribution-NonCommercial-NoDerivatives 4.0 International ( CC BY-NC-ND 4.0)

                History
                : 15 June 2019
                : 23 August 2019
                Categories
                Clinical Research

                glaucoma,pressure,retina,silicone oils
                glaucoma, pressure, retina, silicone oils

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