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Continuous real-time pressure monitoring during pars plana vitrectomy

Session Details

Session Title: Vitreoretinal Surgery III

Session Date/Time: Friday 12/09/2014 | 08:00-10:00

Paper Time: 08:56

Venue: Boulevard E

First Author: : T.Rossi ITALY

Co Author(s): :    G. Querzoli   C. Malvasi   A. Rossi   G. Angelini     

Abstract Details

Purpose:

to monitor intraocular pressure (IOP) continuously in course of pars plana vitrectomy (PPV) surgery, in order to evaluate if, how often and for how long intra-ocular pressure is above or below safe values.

Setting:

Prospective, interventional series, single surgeon

Methods:

20 consecutive procedures including PPV alone or in combination to phacoemulsification were considered and IOP monitored in real time, through a sensor located within the infusion cannula. Six measures per second with <1 mmHg resolution were recorded throughout the entire surgical procedure and surgical video recorded as well, in order to compare pressure levels to surgical manoeuvers.

Results:

IOP remained within 5 mmHg of pre-set value for more than 80% of surgery, both with a gravity or forced ventilation infusion system. IOP peaks of a few seconds duration reached 100 mmHg during phacoemulsification and certain PPV surgical manoeuvers including PFCL injection, scleral depression. Hypotony was far less common and of scarce clinical relevance.

Conclusions:

Continuous IOP monitoring is feasible and reliable; both a gravity and ventilated system allow proper infusion control and provide sufficient protection against unwanted hypotony. Pressure spikes are frequently associated with different surgical manipulation of frequent occurrence. Improvement of infusion line system safety may pass through a better understanding and reaction to pressure fluctuations both underneath and, especially, over the desired pressure.

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