Tommaso Rossi1, Giorgio Querzoli2, Aldo Gelso3, Giampiero Angelini4, Alessandro Rossi4, Paolo Corazza5, Laura Landi5, Serena Telani5, Guido Ripandelli6. 1. San Martino Hospital, Largo Rosanna Benzi 2, 16100, Genoa, Italy. tommaso.rossi@usa.net. 2. University of Cagliari, DICAAR, Cagliari, Italy. 3. UO oculistica Clinica Villa dei Fiori, Acerra - Napoli, Acerra, Italy. 4. Optikon 2000 Inc., Rome, Italy. 5. San Martino Hospital, Largo Rosanna Benzi 2, 16100, Genoa, Italy. 6. IRCCS Fondazione G.B. Bietti - Onlus, Rome, Italy.
Abstract
PURPOSE: To study the efficacy of a novel device intended to control infusion pressure based on mean ocular perfusion pressure (MOPP) during pars plana vitrectomy (PPV). METHODS: An arm blood pressure cuff connected to a vitrectomy machine calculated mean arterial pressure (MAP), while a pressure sensor close to the infusion trocar measured intraocular pressure (IOP). MOPP was calculated in real time in 36 consecutive patients undergoing PPV, who were divided into two groups. The device lowered IOP every time that calculated MOPP fell below 30 mmHg in the Control ON group (18 patients), while no action was taken in the Control OFF group (18 patients). RESULTS: Baseline IOP and blood pressure were similar between groups. The Control ON group had significantly lower average intraoperative IOP (30.5 ± 2.1 vs. 35.9 ± 6.9 mmHg; p = 0.002) and higher MOPP (56.4 ± 5.9 vs. 49.7 ± 6.1 mmHg) than the Control OFF group. The Control ON group also spent less time at MOPP < 10 mmHg and < 30 mmHg: 0 vs. 3.40 ± 2.38 min (p < 0.001) and 9.91 ± 7.15 vs. 16.13 ± 8.12 min (p = 0.02), respectively. CONCLUSIONS: The MOPP control device effectively maintained lower IOP and higher MOPP throughout surgery. It also helped avoid dangerous IOP peaks and MOPP dips, allowing patients to spend less time at MOPP of < 10 and < 30 mmHg.
PURPOSE: To study the efficacy of a novel device intended to control infusion pressure based on mean ocular perfusion pressure (MOPP) during pars plana vitrectomy (PPV). METHODS: An arm blood pressure cuff connected to a vitrectomy machine calculated mean arterial pressure (MAP), while a pressure sensor close to the infusion trocar measured intraocular pressure (IOP). MOPP was calculated in real time in 36 consecutive patients undergoing PPV, who were divided into two groups. The device lowered IOP every time that calculated MOPP fell below 30 mmHg in the Control ON group (18 patients), while no action was taken in the Control OFF group (18 patients). RESULTS: Baseline IOP and blood pressure were similar between groups. The Control ON group had significantly lower average intraoperative IOP (30.5 ± 2.1 vs. 35.9 ± 6.9 mmHg; p = 0.002) and higher MOPP (56.4 ± 5.9 vs. 49.7 ± 6.1 mmHg) than the Control OFF group. The Control ON group also spent less time at MOPP < 10 mmHg and < 30 mmHg: 0 vs. 3.40 ± 2.38 min (p < 0.001) and 9.91 ± 7.15 vs. 16.13 ± 8.12 min (p = 0.02), respectively. CONCLUSIONS: The MOPP control device effectively maintained lower IOP and higher MOPP throughout surgery. It also helped avoid dangerous IOP peaks and MOPP dips, allowing patients to spend less time at MOPP of < 10 and < 30 mmHg.
Entities:
Keywords:
Intraocular pressure; Mean arterial pressure; Ocular perfusion pressure; Pars plana vitrectomy
Authors: John H K Liu; Parag A Gokhale; Richard T Loving; Daniel F Kripke; Robert N Weinreb Journal: J Ocul Pharmacol Ther Date: 2003-08 Impact factor: 2.671
Authors: Alok S Bansal; Jason Hsu; Sunir J Garg; Arunan Sivalingam; James F Vander; Mark Moster; Joseph I Maguire; Carl D Regillo Journal: Ophthalmology Date: 2012-07-26 Impact factor: 12.079