Guoji Yanke Zazhi (Dec 2015)
Drug treatment for high IOP at early stage after vitrectomy for macular hole caused by high myopia
Abstract
AIM:To study the effect of only latanoprost eye drops or combined with other medicines on lowering intraocular pressure(IOP)after early pars plana vitrectomy(PPV)for macular hole without retinal detachment caused by high myopia.METHODS:One hundred and eighty-eight cases(205 eyes)suffered from macular hole caused by high myopia without reinal detachment who underwent PPV combined with C3F8 tamponade were studied retrospectively and measured the IOP at 1wk after surgeries. The patients whose IOP was 22～29mmHg were named as group A. Then they were divided randomly into two subgroups, group A1(treated by carteolol eye drops)and subgroup A2(treated by latanoprost eye drops). The patients whose IOP was 30～39mmHg were named as group B. Then they were divided randomly into two subgroups, group B1(treated by both carteolol and brimonidine tartrate eye drops)and subgroup B2(treated by both latanoprost and carteolol eye drops). The patients whose IOP was ≥40mmHg were named as group C and they were all treated by rapid intravenous injection of 20% Mannitol. Meanwhile, they were divided randomly into two subgroups, group C1(treated by carteolol,brimonidine tartrate and brinzolamide eye drops )and subgroup C2(treated by carteolol,brimonidine tartrate and latanoprost eye drops). Continuous observation lasted 3d. If IOP dropped to below 21 mmHg, we considered it valid. And then,compare the effectiveness, IOP reduction and the average effective duration. RESULTS:Eighty-nine eyes met the criteria of high IOP and IOP of 70 eyes(78.6%)increased within 3d after operations. There were 31 eyes in group A including 14 eyes in group A1 and 17 eyes in group A2.The number of effective cases of the two groups was 5(35.7%)and 13(76.5%)respectively, the difference was statistically significant(χ2=5.24,P=0.03).The IOP reduction of the two groups were 4.21±1.22mmHg(24%), 8.76±3.03mmHg(29.6%), respectively, and the difference was statistically significant(t=5.73,Pt=2.85,P=0.012).There were 32 eyes in group B including 17 eyes in group B1 and 15 eyes in group B2.The number of effective cases of the two groups was 9(52.9%)and 11(73.3%),respectively, and the difference was not statistically significant(χ2=1.40,P=0.30 ).The IOP reduction of the two groups was 10.59±2.72mmHg(36.9%), 16.53±2.67mmHg(43.8%)respectively, and the difference was statistically significant(t=6.27,Pt=3.34,P=0.004). There were 26 eyes in group C including 14 eyes in group C1 and 12 eyes in group C2.The number of effective cases of the two groups was 9(64.3%)and 8(66.7%)respectively, and the difference was not statistically significant(P=0.70).The IOP reduction of the two groups was 22.00mmHg(51.0%),31.45mmHg(59.3%)respectively, and the difference was statistically significant(t=18.35,Pt=2.97,P=0.009).CONCLUSION:PPV treating macular hole caused by high myopia is associated with highe rates of IOP increasing, which generally occurs within 3d after the operation. Alone or in combination, latanoprost eye drops can effectively reduce IOP.
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