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ELEVATED INTRAOCULAR PRESSURE FOLLOWING PARS PLANA VITRECTOMY DUE TO TRAPPED GAS IN THE POSTERIOR CHAMBER.

TitleELEVATED INTRAOCULAR PRESSURE FOLLOWING PARS PLANA VITRECTOMY DUE TO TRAPPED GAS IN THE POSTERIOR CHAMBER.
Publication TypeJournal Article
Year of Publication2016
AuthorsChin, Eric K., Almeida David R. P., Strohbehn Austin L., Mahajan Vinit B., Russell Stephen R., and Folk James C.
JournalRetin Cases Brief Rep
Volume10
Issue4
Pagination334-7
Date Published2016 Fall
ISSN1937-1578
KeywordsAged, Endotamponade, Female, Gases, Humans, Intraocular Pressure, Male, Middle Aged, Ocular Hypertension, Posterior Eye Segment, Vitrectomy
Abstract

PURPOSE: Elevated intraocular pressure is relatively common following pars plana vitrectomy and intraocular gas tamponade. We discuss a series of patients who experienced elevated intraocular pressure from pupillary block and angle closure secondary to trapped gas in the posterior chamber.

METHODS: Case series.

RESULTS: Case 1 is a patient who underwent pars plana vitrectomy for retinal detachment repair. The intraocular pressure was elevated on postoperative Day 3 because of trapped gas in the posterior chamber, and it did not lower with prone positioning, maximal medical therapy, and laser peripheral iridotomies. Aspiration of the trapped gas was done with the patient sitting upright using a 27-gauge needle at the limbus, which was curative. Case 2 provides anterior-segment optical coherence tomography images that confirmed the location of the trapped gas resulting in angle closure. Case 3 demonstrates the unfortunate sequelae of a central retinal artery occlusion following delayed recognition of this entity. Case 4 highlights the challenges encountered when migratory gas is also seen elsewhere in the eye.

CONCLUSION: Clinicians should be aware of elevated intraocular pressure secondary to trapped gas in the posterior chamber, which may be recalcitrant to medical therapy. Aspiration of the trapped gas can alleviate both pupillary block and angle closure without compromising the gas tamponade.

DOI10.1097/ICB.0000000000000256
Alternate JournalRetin Cases Brief Rep
PubMed ID26630244