1.Increased intraocular pressure in patients with Carotid-Cavernous Fistula seen at a Tertiary Eye Care Center
Patricia Anne C. Concepcion ; Nilo Vincent dG. FlorCruz II
Philippine Journal of Ophthalmology 2022;47(2):70-75
Objectives:
We described the demographic and clinical profiles of patients with carotid-cavernous fistula
(CCF), determined the prevalence of increased intraocular pressure (IOP), and described the IOP outcomes
after endovascular treatment.
Methods:
This was a single-center, retrospective review of records of patients with clinical signs and radiologic
evidence of CCF from January 2012 to December 2017. Outcome measures included the prevalence of
increased IOP in those with CCF, mean and range of IOPs, average number of IOP-lowering medications
needed, and percentage of eyes with normal, controlled, and uncontrolled IOP before and after endovascular
intervention.
Results:
Ninety-six (96) eyes of 92 patients with radiologic evidence of CCF on 4-vessel cerebral angiography
were included. Fifty-nine (59) percent were between the ages of 20 to 39 years. Majority (65%) were males.
Direct CCFs accounted for 70% of cases. Increased IOP was the third most common ocular sign with a
prevalence of 78%, ranging from 10 to 56 mmHg (mean 20.3 ± 8.0). The average number of antiglaucoma
medications for IOP control was 2. Eleven (11) underwent definitive management for CCF. Post-treatment,
33% of 13 eyes had normal, 27% controlled, and 40% uncontrolled IOPs.
Conclusion
There was a high prevalence of increased IOP in patients with CCF. Those who did not achieve
IOP control should be referred for endovascular intervention to prevent serious complications, including
secondary glaucoma.
Intraocular Pressure
2.Descemet’s membrane detachment in a corneal graft after removal of a Baerveldt Shunt Intraluminal Stent
Karlo Marco DR. Claudio ; Rainier Victor A. Covar ; Ruben Lim Bon Siong ; Patricia Anne C. Concepcion
Philippine Journal of Ophthalmology 2022;47(2):101-105
Objective:
We reported a case of Descemet's membrane detachment (DMD) following ripcord
removal of a Baerveldt shunt in a post-corneal transplant eye, and the interventions done.
Method:
This is a case report
Results:
A 65-year-old male with multiple surgeries (phacoemulsification, two corneal transplants,
and Baerveldt shunt implantation) in the right eye developed increased intraocular pressures,
prompting removal of the intraluminal stent (ripcord) of the shunt. This was complicated by hypotony
and DMD. Ripcord reinsertion and viscoelastic injection were performed to reattach the Descemet's
membrane (DM) but failed. 0.1mL of 14% perfluoropropane (C3F8) gas was injected into the anterior
chamber that successfully reattached the DM with return to pre-operative best-corrected visual acuity
after 1 week.
Conclusion
Injection of an expansive gas (C3F8) was effective in repairing a corneal graft DMD in
an eye with a Baerveldt shunt.
Glaucoma Drainage Implants
;
Corneal Transplantation