Serial paracenteses in the management of acute elevations of intraocular pressure. Ophthalmology 2002 Sep;109(9):1604-6
Date
09/05/2002Pubmed ID
12208705DOI
10.1016/s0161-6420(02)01126-0Scopus ID
2-s2.0-0036713598 (requires institutional sign-in at Scopus site) 21 CitationsAbstract
OBJECTIVE: To study the effectiveness of serial paracenteses in eyes with symptomatic elevated intraocular pressure (IOP).
DESIGN: Retrospective, noncomparative, interventional case series.
PARTICIPANTS: Five eyes of four patients with acute elevations in IOP.
METHODS: A 5-year review of records was performed in one practice (LP) to identify patients who underwent more than one paracentesis for control of symptomatic increases in IOP when greater than 30 mmHg. Five eyes of four patients were identified, and charts were analyzed for cause and duration of elevated pressure, control of symptoms associated with elevated pressure, number of paracenteses, and visual outcome. All patients received topical anesthetic (proparacaine 0.5%) before paracentesis, and topical ciprofloxacin, 0.35%, or tobramycin, 0.3%, before and after paracentesis, which was performed at the temporal limbus with a 0.75-mm sterile surgical blade.
RESULTS: Paracentesis provided almost immediate symptomatic relief in all cases. The procedure could be repeated easily whenever symptoms recurred. The average number of paracenteses performed was three. No complications of paracentesis were noted. Visual outcomes were variable and dependent on the etiology of elevated IOP. Two eyes with neovascular glaucoma had poor visual outcomes. None of the other three eyes lost vision because of increased IOP.
CONCLUSIONS: Acute symptomatic elevations of IOP in patients with a deep anterior chamber can be effectively treated with paracentesis. In selected cases, serial paracenteses may obviate the need for filtration surgery. If filtration surgery is required, serial paracenteses may allow it to be scheduled electively rather than emergently.
Author List
Carnahan MC, Platt LWAuthors
Lawrence W. Platt MD Associate Professor in the Ophthalmology and Visual Sciences department at Medical College of WisconsinLawrence W. Platt MD Associate Professor in the Ophthalmology and Visual Sciences department at Medical College of Wisconsin
MESH terms used to index this publication - Major topics in bold
Acute DiseaseAdult
Anterior Chamber
Female
Humans
Intraocular Pressure
Male
Middle Aged
Ocular Hypertension
Paracentesis
Reoperation
Retrospective Studies
Treatment Outcome
Visual Acuity
