Abstract
Background
Although many investigators have previously reported various ocular complications induced by vitrectomy, little is known about post-operative morphological changes in the optic disc. The purpose of this study is to evaluate the effect of vitrectomy and fluid–air (F-A) exchange on the post-operative morphology of the optic disc.
Methods
We examined 31 eyes that had undergone vitrectomy for macular holes (22 eyes) or epiretinal membranes (9 eyes). Only the patients with macular holes were treated by fluid–air exchange. Morphological changes in the optic disc were evaluated using the Heidelberg Retina Tomograph.
Results
C/D area ratios significantly decreased for 6 months post-operatively. The rim volumes significantly increased for 1 month following surgery. Cup volumes significantly decreased at 3 months after surgery. No significant change of mean cup depth was observed post-operatively. The eyes that had not been subjected to F-A exchange showed no significant morphological change following surgery. In contrast, the eyes that had undergone F-A exchange showed significant decrease in C/D area ratio and cup volume and an increase in rim volume and mean cup depth for considerable periods following surgery. Any of the patients showed no post-operative visual field loss.
Conclusion
Whereas no visual field loss is observed, vitrectomy with F-A exchange induces morphological changes in the optic disc for significant periods following surgery.
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References
Adachi M, Takahashi K, Nishikawa M, Miki H, Uyama M (1996) High intraocular pressure-induced ischemia and reperfusion injury in the optic nerve and retina in rats. Graefes Arch Clin Exp Ophthalmol 234:445–451
Blair NP, Shaw WE, Dunn Jr R, Tsukarhara Y, Floro C, Rusin MM (1991) Limitation of retinal injury by vitreoperfusion initiated after onset of ischemia. Arch Ophthalmol 109:113–118
Chauhan BC, LeBlanc RP, McCormick TA, Rogers JB (1994) Test-retest variability of topographic measurements with confocal scanning laser tomography in patients with glaucoma and control subjects. Am J Ophthalmol 118:9–15
Ezra E, Arden GB, Riordan-Eva P, Aylward GW, Gregor ZJ (1996) Visual field loss following vitrectomy for stage 2 and 3 macular holes. Br J Ophthalmol 80:519–525
Horiguchi M, Miyake Y (1991) Effect of temperature on electroretinograph readings during closed vitrectomy in humans. Arch Ophthalmol 109:1127–1129
Hutton WL, Fuller DG, Snyder WB, Fellman RL, Swanson WH (1996) Visual field defects after macular hole surgery. A new finding. Ophthalmology 103:2152–2158
Janknecht P, Funk J (1994) Optic nerve head analyser and Heidelberg retina tomograph: accuracy and reproducibility of topographic measurements in a model eye and in volunteers. Br J Ophthalmol 78:760–768
Kerrison JB, Haller JA, Elman M, Miller NR (1996) Visual field loss following vitreous surgery. Arch Ophthalmol 114:564–569
Kuhn F, Morris R, Massey M (1991) Photic retinal injury from endoillumination during vitrectomy. Am J Ophthalmol 111:42–46
Matsuda M, Tano Y, Inaba M, Manabe R (1986) Corneal endothelial cell damage associated with intraocular gas tamponade during pars plana vitrectomy. Jpn J Ophthalmol 30:324–329
McDonald HR, Harris MJ (1988) Operating microscope-induced retinal phototoxicity during pars plana vitrectomy. Arch Ophthalmol 106:521–523
Mitamura Y, Takeuchi S, Kasai H, Yamamoto S, Matsumura S, Kudou H (1998) [Corneal endothelial cell damage associated with pars plana vitrectomy]. Nippon Ganka Gakkai Zasshi 102:59–63
Moorhead LC, Redburn DA, Merritt J, Garcia CA (1979) The effects of intravitreal irrigation during vitrectomy on the electroretinogram. Am J Ophthalmol 88:239–245
Ohji M, Nao IN, Saito Y, Hayashi A, Tano Y (1999) Prevention of visual field defect after macular hole surgery by passing air used for fluid–air exchange through water. Am J Ophthalmol 127:62–66
Parrish R, Gass JD, Anderson DR (1982) Outer retina ischemic infarction—a newly recognized complication of cataract extraction and closed vitrectomy. 2. An animal model. Ophthalmology 89:1472–1477
Russell SR, Hageman GS (2001) Optic disc, foveal, and extrafoveal damage due to surgical separation of the vitreous. Arch Ophthalmol 119:1653–1658
Tamai K, Toumoto E, Majima A (1997) Protective effects of local hypothermia in vitrectomy under fluctuating intraocular pressure. Exp Eye Res 65:733–738
Weinreb RN, Lusky M, Bartsch DU, Morsman D (1993) Effect of repetitive imaging on topographic measurements of the optic nerve head. Arch Ophthalmol 111:636–638
Zangwill LM, van Horn S, de Souza Lima M, Sample PA, Weinreb RN (1996) Optic nerve head topography in ocular hypertensive eyes using confocal scanning laser ophthalmoscopy. Am J Ophthalmol 122:520–525
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Ohashi, H., Kasuga, Y., Hata, N. et al. Morphological changes in the optic disc after vitrectomy and fluid–air exchange. Graefe's Arch Clin Exp Ophthalmol 242, 484–488 (2004). https://doi.org/10.1007/s00417-004-0877-z
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DOI: https://doi.org/10.1007/s00417-004-0877-z