The use of Ologen Collagen Matrix implants to treat ocular hypotony developing after trabeculectomy: A case series.

PURPOSE: Late hypotony is an undesirable and challenging complication of glaucoma surgery. We describe our use of the Ologen Collagen Matrix to treat late hypotony developing after trabeculectomy. STUDY DESIGN: A retrospective study performed at three eye surgery centers in Brazil. PARTICIPANTS: Eighteen patients who underwent 19 eye surgeries. INTERVENTION: Subconjunctival Ologen was implanted at the trabeculectomy sites to treat over-filtering or leaking blebs in patients experiencing late hypotony after trabeculectomy (obtained 6 months after glaucoma surgery). The primary outcome was the intraocular pressure (IOP); we gathered preoperative data records from 19 Ologen treated eyes and days 1, 7, 30, 60, and 180 postoperatively. The secondary outcomes included visual acuity and macular thickness measured via optical coherence tomography; we compared preoperative data to subsequent ones up to sixth-month-evolution. RESULTS: Over the 6-month period, the IOP rose from 2.89 ± 1.59 mmHg preoperatively to 8.21 ± 3.46 mmHg (p = 0.0001). Visual acuity improved from 0.33 ± 0.29 to 0.21 ± 0.31 LogMar (p = 0.0013). Macular thickness fell from 325.62 ± 58.7 to 283.08 ± 47.35 µm (p = 0.0097). We encountered two complications: one related to suture dehiscence following an ocular trauma and one instance of transitory choroidal detachment. CONCLUSION: Subconjunctival Ologen implants preserved bleb function and successfully treated post-trabeculectomy hypotony as revealed by data collected at the 6-month follow-up. Longer follow-up is necessary to confirm long-term efficacy and safety. There are no financial conflicts of interest to disclose.

Spontaneous scleral rupture associated with retinochoroidal coloboma / Ruptura espontânea de esclera associada a coloboma coriorretiniano

Abstract We reported a case of ocular hypotony due to spontaneous scleral rupture in retinochoroidal coloboma and the treatment which was performed. This is a prospective case report in which a 21-year-old woman complained of abrupt vision loss in her left eye. Ocular hypotony due to spontaneous scleral rupture in retinochoroidal coloboma was identified through tests. An ultrassonography confirmed the scleral lesion but magnetic resonance imaging and fluorescein angiography have also proven to be useful. Due to the posterior location of the perforation, we opted for a sub-tenon injection of autologous blood and intraocular gas tamponade, which were successful, resulting in improved visual acuity and intraocular pressure. In this case, an alternative to invasive surgical procedure in the treatment of spontaneous scleral perforation and retinochoroidal coloboma was presented.

Resumo Relatamos um caso de hipotensão ocular secundária a ruptura escleral espontânea em coloboma coriorretiniano e o tratamento realizado. Trata-se de estudo de caso prospectivo de uma mulher de 21 anos de idade que se apresentou queixando perda súbita de visão no olho esquerdo. Ao exame, foi evidenciado hipotensão ocular em virtude de ruptura espontânea de esclera em coloboma coriorretiniano. Ultrassonografia confirmou a lesão da esclera embora ressonância magnética e angiofluoresceinografia também tenham sido úteis. Em virtude da localização posterior da perfuração, optamos por injeção sub-tenoniana de sangue autólogo e tamponamento intraocular com gás, que demonstraram ser úteis, resultando em melhora da acuidade visual e da pressão intraocular. Neste caso, apresentamos uma alternativa a procediemnto cirúrgico invasivo para tratamento de perfuração espontânea de esclera em coloboma coriorretiniano.

The clinical characteristic analysis of idiopathic hypotony maculopathy in a series of 18 patients / 中华眼底病杂志

Objective To summarize the clinical features in idiopathic hypotony maculopathy.Methods A retrospective case series study.Eighteen eyes of 18 patients who were diagnosed with idiopathic hypotony maculopathy were enrolled in the Second Affiliated Hospital of Wenzhou Medical University from August 2012 to December 2017.There were 8 males (8 eyes) and 10 females (10 eyes).All patients underwent examinations including BCVA,optometry,slit lamp microscope,fundus color photography,UBM,B-mode ultrasound,OCT,FFA and axial length (AL).BCVA was recorded with logMAR acuity.The results of affected eyes and contralateral healthy eyes were compared.Paired t test was performed to compare the intraocular pressure (IOP),diopter and AL of the affected eyes and contralateral healthy eyes.Results Among 18 eyes,there were 6 eyes with logMAR BCVA＜ 1.0,10 eyes with logMAR BCVA 1.0-2.0,2 eyes with light perception.The average diopter was +2.32± 1.78 D.The average IOP was 5.18± 1.38 mmHg (1 mmHg=0.133 kPa).The average AL was 20.92± 1.61 mm.The differences of IOP (t=21.6,P＜ 0.000),diopter (t=5.9,P=0.002) and AL (t=9.13,P＜0.000) between the affected eyes and contralateral healthy eyes were significant.The inflammatory reaction in the anterior segment was observed in 13 eyes (72.22％).In the posterior segment,all the eyes were documented with chorioretinal folds,optic disc swelling and retinal phlebectasia were also demonstrated in 14 eyes,while with macular uplift in 7 eyes.In the UBM and gonioscope examination,the angle chamber was open in all patients with ciliary body cyst in 6 eyes,while no ciliary body detachment was detected.All eyes had been examined with B-scan ultrasound and found the increasing thickness of eye ball in all eyes,and nodular changes in the optic papilla in 5 eyes.The chorioretinal folds were further confirmed by OCT with the appearance of the gear shape,much more obviously in the chomid than that in retina.In the FFA,fluorescein leakage was found around the optic disc in 13 eyes at the late stage,while there was no obvious abnormal leakage in the macular or poster part of retina.Conclusions Idiopathic hypotony maculopathy could present with various clinical manifestations.The choroiretinal folds is typical clinical sign.

Maculopatia hipotônica pós ciclodiálise traumática por arma de fogo / Hypotonic maculopathy post traumatic cyclodialysis with firearms

Resumo Um traumatismo ocular contuso pode gerar uma vasta gama de lesões intraoculares que são dependentes da quantidade de energia que o objeto transfere ao olho durante o impacto. As lesões da íris, malha trabecular e corpo ciliar podem repercutir na drenagem do humor aquoso. A ocorrência de uma ciclodiálise caracterizada pelo descolamento do corpo ciliar da parede escleral, criando uma comunicação entre a câmara anterior e o espaço supracoroidiano, pode provocar importante redução da pressão intraocular. Esta diminuição pressórica é a responsável pela ocorrência da maculopatia hipotônica que pode cursar com diminuição irreversível da acuidade visual. Não existe consenso na literatura sobre o tratamento das ciclodiálises. Neste relato, descrevemos um caso de ciclodiálise traumática pós impacto com projétil de arma de fogo tratada com aplicação de laser de argônio.

Abstract Blunt eye trauma can generate a wide range of intraocular lesions that are dependent on the amount of energy the object transfers to the eye during the impact. Lesions of the iris, trabecular meshwork and ciliary body may influence aqueous humor drainage. The cyclodialysis which is characterized by the detachment of ciliary body from the scleral wall, creating a communication between the anterior chamber to supracoroid space, can cause a several reduction of intraocular pressure. This pressure decrease is responsible for the occurrence of hypotonic maculopathy which may induce a severe impact on visual acuity. There is no consensus in the literature about cyclodialysis treatment. In this report, we describe a case of traumatic cyclodialysis after impact with a firearm projectile treated with argon laser photocoagulation.

Cionni-modified capsular tension ring for surgical repair of cyclodialysis after trabeculectomy: a case report.

BACKGROUND: To report a case for repair of cyclodialysis after trabeculectomy with Cionni-modified capsular tension ring. CASE PRESENTATION: A 64-year-old man who had undergone trabeculectomy of his left eye 3 months earlier visited our clinic owing to blurred vision. His visual acuity was 20/2000 and the intraocular pressure (IOP) was 6 mmHg. Slit-lamp examination showed a shallow anterior chamber and dense cataract. Ultrasound biomicroscopy revealed 360 ° detachment of the ciliary body and suspected cyclodialysis of the trabeculectomy incision. Choroidal detachment was confirmed by B-scan ultrasonography and optical coherence tomography. Phacoemulsification was performed in which a foldable intraocular lens (IOL) was implanted in the capsular bag and a Cionni-modified capsular tension ring (MCTR) was inserted into the ciliary sulcus. The maximum focal point of the MCTR was rotated to the site of the most severe cyclodialysis and the MCTR was sutured to the sclera through its two eyelets. The patient's best-corrected visual acuity improved to 30/50 and the IOP increased to 16 mmHg after surgery. Gonioscopy and ultrasound biomicroscopy confirmed closure of the cyclodialysis and resolution of choroidal detachment. CONCLUSIONS: Phacoemjulsification with implantation of an intraocular lens combined with insertion of an MCTR into the ciliary sulcus appears to be a relatively safe, effective, minimally invasive method for repairing cyclodialysis in cataract patients. Although the technique yielded good results and appeared to be safe in one patient, further studies are necessary to validate the findings on more patients and with a long-term follow-up.

Enxerto de retalho escleral de doador como tratamento definitivo de maculopatia hipotônica pós trabeculectomia / Scleral patch as a definitive treatment for hypotonic maculopathy after trabeculectomy

RESUMO Paciente do sexo feminino, portadora de glaucoma juvenil sem controle clínico adequado, foi submetida à trabeculectomia com mitomicina C, após a qual, desenvolveu hipotensão ocular refratária às medidas conservadoras, evoluindo com um quadro de maculopatia hipotônica. Foi realizado um implante de enxerto de retalho escleral de doador sobre a fístula, com resolução do quadro e ganho de acuidade visual. A enxertia de retalho escleral de doador mostrou-se uma terapia adequada para correção da hipotensão ocular por bolha hiperfiltrante pós trabeculectomia. O cirurgião deve considerar o emprego dessa técnica ao programar a revisão destes casos.

ABSTRACT A female patient with juvenile glaucoma without clinical control underwent a trabeculectomy with mitomycin C, and developed eye hypotension which did not respond to conservative treatment, with subsequent hypotonic maculopathy. The patient was treated using a scleral patch provided by a donor above the fistula, which improved intraocular pressure and visual acuity. The use of the scleral patch above the fistula seems an adequate therapy to treat ocular hypotension due to the over-filtering trabeculectomy bubble. The surgeon should consider this technique when planning surgical solutions for such cases.

Direct cyclopexy surgery for post-traumatic cyclodialysis with persistent hypotony: ultrasound biomicroscopic evaluation / Ciclopexia direta em ciclodiálise pós-traumática com hipotonia ocular persistente -acompanhamento por biomicroscopia ultrassônica (UBM)

Cyclodialysis is a relatively rare condition usually caused by ocular injury; however, it can also be caused iatrogenically during intraocular surgery. Hypotony maculopathy is the most important complication and the primary reason for visual loss. Clinical diagnosis using gonioscopy may be difficult, and ultrasound biomicroscopy (UBM) can be an alternative. There are different kinds of treatments, and the optimal one remains controversial. Here we describe a case of traumatic cyclodialysis with persistent ocular hypotony treated by direct cyclopexy, as illustrated by UBM performed before and after surgery.

Ciclodiálise é uma condição relativamente rara, geralmente devido a um trauma ocular, mas também pode ser causada iatrogenicamente como consequência de cirurgia intraocular. A maculopatia hipotônica é a complicação mais importante e a principal razão para a perda visual nessa situação. O diagnóstico clínico por gonioscopia pode ser difícil e a biomicroscopia ultrassônica (UBM) pode ser uma alternativa. Existem diferentes tipos de tratamentos e algumas controvérsias sobre a melhor opção. Neste relato, nós descrevemos um caso de ciclodiálise traumática com hipotonia ocular persistente tratado por cyclopexia direta avaliado por UBM antes e depois da cirurgia.

Suturing pattern of the scleral incision affect the postoperative intraocular pressure after 23G vitrectomy / 中华眼底病杂志

Objective To observe the relationship between the suturing patterns to close the scleral incision and postoperative intraocular pressure (IOP) in 23G minimally invasive vitrectomy.Methods Eighty eyes of 80 patients with vitreoretinal diseases,who were treated with primary 23G minimally invasive vitrectomy,were enrolled in this prospective clinical study.Patients with poor closed scleral incision which need suturing were excluded from this study.The corrected visual acuity ranged from hand movement to 0.2.The IOP ranged from 7.9 to 19.8 mm Hg (1 mm Hg=0.133 kPa),with the mean of (13.9±1.8)mm Hg.The eyes were randomly divided into three groups:group A (20 eyes),suturing all three scleral puncture after vitrectomy; group B (20 eyes),suturing only two upper scleral puncture,but not the lower infusion puncture after vitrectomy; group C (40 eyes),no suturing for all 3 scleral puncture after vitrectomy.All patients underwent 23G vitrectomy only.The corrected visual acuity and IOP were observed after surgery.Results The corrected visual acuity were 0.1 0.3,0.2-0.5,0.3-0.8 in one,seven and 14 days after surgery,respectively.No one in group A,B experienced hypotony in one,three,seven and 14 days after surgery.Thirteen (32.5％),five (12.5 ％),two eyes (5.0％) in group C experienced hypotony in one,three and seven days after surgery.Seven eyes (17.5％) experienced severe hypotony (＜5 mm Hg)in 14 day after surgery in group C.The difference was statistically significant compared the incidence of hypotony in group C with group A,B respectively at different time points after surgery (xx2 =16.82,P=0.007).The difference was statistically significant compared the incidence of hypotony in group C at different time points after surgery (x2 =11.64,P=0.003).The difference was no significant compared the IOP between group A and B at different time points after surgery (F=1.618,P=0.205).Compared the IOP of group C to group A and B,the difference was statistically significant in one and three days after vitrectomy (F=9.351,P=0.000); but not statistically significant in seven and 14 days after vitrectomy (F=0.460,P=0.633).Conclusions Whether or not suturing the scleral punctures is closely related to postoperative hypotony in 23G vitrectomy.Suturing only the two upper scleral punctures can reduce the occurrence of postoperative hypotony.

Diagnosis and treatment of hyperfiltering blebs / Diagnóstico e tratamento de bolsas fistulantes hiperfuncionantes

PURPOSE: To report on a new treatment for hyperfiltering bleb as well as its diagnostic criteria. METHODS: Twenty eyes with hypotony due to hyperfiltering bleb caused by trabeculectomy with mitomicin C were treated with bleb resection. The diagnosis of hyperfiltering bleb followed these criteria: intraocular pressure lower than six mmHg (Goldmann tonometer); no inflammation in the anterior segment; presence of an elevated and/or diffuse and avascular bleb with or without microcysts; negative Seidel test; no ciliochoroidal detachment found with ultrasound biomicroscopy. We registered the following data pre and post operatively: type of glaucoma, visual acuity, bleb aspect and fundoscopic findings. A successful resolution of hypotony was achieved when intraocular pressure ranged from six to 14 mmHg with or without antiglaucomatous medication. RESULTS: At a minimum follow-up of 19 months ocular hypotony had been reversed in all eyes. At the last exam, intraocular pressure varied from eight to 14 mmHg in 18 (90 percent) eyes; 12 (66.7 percent) eyes had no medication and six (33.3 percent) used antiglaucomatous medication. In two (10 percent) eyes, another trabeculectomy was necessary to control intraocular pressure. Hypotonic maculopathy developed preoperatively in seven eyes and was reversed after bleb resection. Visual acuity improved in 15 (75 percent) eyes but did not change in five (25 percent). CONCLUSION: Bleb resection is a safe and adequate treatment for ocular hypotony due to hyperfiltering bleb. It also restores vision in a considerable number of patients. The diagnosis of hyperfiltering bleb must follow rigorous criteria.

OBJETIVO: Relatar os resultados de uma nova técnica para o tratamento de bolsa hiperfuncionante, assim como seus critérios diagnósticos. MÉTODOS: Vinte olhos (20 pacientes) com hipotonia ocular causada por bolsa hiperfuncionante após trabeculectomia com mitomicina C foram tratados com ressecção da bolsa. O diagnóstico de bolsa hiperfuncionante obedeceu aos seguintes critérios: pressão intraocular inferior a seis mmHg (tonometria de Goldmann); ausência de inflamação do segmento anterior ocular; presença de bolsa fistulante elevada e/ou difusa e avascular com ou sem microcistos; teste de Seidel negativo; ausência de descolamento ciliocoroidiano ao exame de UBM. Foram registrados no pré e pós-operatório: o tipo de glaucoma, a acuidade visual, o aspecto da bolsa e os achados oftalmoscópicos. A resolução da hipotonia foi alcançada quando a pressão intraocular variou de seis a 14 mmHg sem ou sob medicação tópica antiglaucomatosa. RESULTADOS: No seguimento mínimo de 19 meses, a hipotonia ocular foi revertida nos 20 olhos. No último exame, a pressão intraocular variou de oito a 14 mmHg em 18 (90 por cento) olhos; 12 (66,7 por cento) olhos sem medicação e seis (33,3 por cento) olhos sob medicação tópica. Em dois (20 por cento) olhos foi necessário nova trabeculetomia para controle da pressão intraocular. Maculopatia hipotônica foi diagnosticada no pré-operatório em sete olhos e foi revertida em todos eles após a ressecção da bolsa. A acuidade visual melhorou em 15 (75 por cento) olhos e não se alterou em cinco (25 por cento). CONCLUSÃO: A ressecção da bolsa é eficaz no tratamento da hipotonia ocular consequente a sua hiperfunção. Esse procedimento também recupera a visão num considerável número de pacientes. O diagnóstico de bolsa hiperfuncionante deve obedecer a critérios rigorosos.

Intraocular pressure, corneal thickness, and corneal hysteresis in Steinert's myotonic dystrophy / Pressão intraocular, espessura corneal e histerese corneal em distrofia miotônica de Steinert

PURPOSE: Low intraocular pressure (IOP) measured by Goldmann applanation tonometry (GAT) is one of the ocular manifestations of Steinert's myotonic dystrophy. The goal of this study was to evaluate the corneal-compensated IOP as well as corneal properties (central corneal thickness and corneal hysteresis) in patients with myotonic dystrophy. METHODS: A total of 12 eyes of 6 patients with Steinert's myotonic dystrophy (dystrophy group) and 12 eyes of 6 age-, race-, and gender-matched healthy volunteers (control group) were included in the study. GAT, Dynamic Contour Tonometry (DCT-Pascal) and Ocular Response Analyzer (ORA) were used to assess the IOP. Central corneal thickness was obtained by ultrasound pachymetry, and corneal hysteresis was analyzed using the ORA device. In light of the multiplicity of tests performed, the significance level was set at 0.01 rather than 0.05. RESULTS: The mean (standard deviation [SD]) GAT, DCT, and corneal-compensated ORA IOP in the dystrophy group were 5.4 (1.4) mmHg, 9.7 (1.5) mmHg, and 10.1 (2.6) mmHg, respectively. The mean (SD) GAT, DCT, and corneal-compensated ORA IOP in the control group was 12.6 (2.9) mmHg, 15.5 (2.7) mmHg, and 15.8 (3.4) mmHg, respectively. There were significant differences in IOP values between dystrophy and control groups obtained by GAT (mean, -7.2 mmHg; 99 percent confidence interval [CI], -10.5 to -3.9 mmHg; P<0.001), DCT (mean, -5.9 mmHg; 99 percent CI, -8.9 to -2.8 mmHg; P<0.001), and corneal-compensated ORA measurements (mean, -5.7 mmHg; 99 percent CI, -10.4 to -1.0 mmHg; P=0.003). The mean (SD) central corneal thickness was similar in the dystrophy (542 [31] µm) and control (537 [11] µm) groups (P=0.65). The mean (SD) corneal hysteresis in the dystrophy and control groups were 11.2 (1.5) mmHg and 9.7 (1.2) mmHg, respectively (P=0.04). CONCLUSIONS: Patients with Steinert's myotonic dystrophy showed lower Goldmann and corneal-compensated IOP in comparison with healthy individuals. Since central corneal thickness and corneal hysteresis did not differ significantly between groups, the lower IOP readings documented in this dystrophy seem not to be related to changes in corneal properties.

OBJETIVOS: Pressão intraocular (PIO) baixa medida por meio da tonometria de aplanação de Goldmann (TAG) é uma das manifestações oculares da distrofia miotônica de Steinert. O objetivo deste estudo foi avaliar a pressão intraocular compensada para as propriedades corneais (espessura corneal central e histerese corneal) em pacientes com distrofia miotônica. MÉTODOS: Um total de 12 olhos de 6 pacientes com distrofia miotônica de Steinert (grupo distrofia) e 12 olhos de 6 voluntários sadios (grupo controle) pareados para idade, raça e sexo foram incluídos no estudo. Tonometria de aplanação de Goldmann, tonometria de contorno dinâmico (TCD-Pascal) e analisador de resposta ocular (ORA) foram usados para medir a pressão intraocular. A espessura corneal central foi obtida por meio da paquimetria ultrassônica e a histerese corneal foi analizada usando o aparelho ORA. RESULTADOS: A pressão intraocular média (desvio-padrão) da TAG, TCD e compensada para a córnea do ORA no grupo distrofia foram 5,4 (1,4) mmHg, 9,7 (1,5) mmHg e 10,1 (2,6) mmHg, respectivamente. A pressão intraocular média (desvio-padrão) da TAG, TCD e compensada para a córnea do ORA no grupo controle foram 12,6 (2,9) mmHg, 15,5 (2,7) mmHg e 15,8 (3,4) mmHg, respectivamente. Houve diferença significativa nos valores da pressão intraocular entre os grupos distrofia e controle obtidas pela TAG (média, -7,2 mmHg; intervalo de confiança (IC) de 99 por cento, -10,5 a -3,9 mmHg; P<0,001), TCD (média, -5,9 mmHg; IC de 99 por cento, -8,9 a -2,8 mmHg; P<0,001) e ORA compensada para córnea (média, -5,7 mmHg; IC de 99 por cento, -10,4 a -1,0 mmHg; P=0,003). A espessura corneal média (desvio-padrão) foi similar nos grupos distrofia (542 [31] µm) e controle (537 [11] µm) (P=0,65). A histerese corneal média (desvio-padrão) nos grupos distrofia e controle foram de 11,2 (1,5) mmHg e 9,7 (1,2) mmHg, respectivamente (P=0,04). CONCLUSÃO: Os pacientes com distrofia miotônica de Steinert apresentaram valores menores de pressão intraocular medidas tanto com Goldmann quanto compensadas para a córnea em comparação com indivíduos sadios. Uma vez que os valores da espessura corneal central e histerese corneal não diferiram significantemente entre os grupos, os valores baixos da pressão intraocular encontrados nos pacientes com distrofia miotônica não parecem estar relacionados com as propriedades corneais.

Descolamento seroso tardio e recorrente da coróide após trabeculectomia: relato de caso / Late and recurrent serous choroidal detachment after trabeculectomy: case report

O presente caso refere-se a um paciente do sexo masculino, de 85 anos de idade, com catarata senil e glaucoma primário de ângulo aberto avançado nos dois olhos, não controlado com medicação máxima, hialose asteróide no OD e degeneração macular relacionada à idade no OE, submetido a facotrabeculectomia em ambos os olhos com mitomicina C. Diante da falência da cirurgia nos dois olhos, mesmo após lise de suturas com laser de argônio, uso de 5-fluorouracil e agulhamento, foi necessário prescrever novamente hipotensores oculares. Com a combinação fixa timolol 0,5 por cento + dorzolamida 2 por cento, o paciente apresentou descolamento seroso coroidiano bilateral com marcante hipotonia; e com brinzolamida 1 por cento o quadro ocorreu apenas no olho esquerdo. Suspensos os colírios, a pressão intraocular se elevava e o descolamento da coróide regredia completamente. O agulhamento associado às aplicações de 5-fluorouracil resolveu a hipertensão ocular.

A case of an 85 year-old white man with bilateral senile cataract and advanced primary open-angle glaucoma uncontrolled with maximal medical therapy, asteroid hyalosis in OD and age-related macular degeneration in OS, submitted to a phacotrabeculectomy OU with mitomycin-C is reported. Because the surgery failed in both eyes, even after laser suture lysis, 5-FU injections and needling, it was necessary to reintroduce hypotensive agents. With the fixed combination of 0.5 percent timolol + 2 percent dorzolamide, a serous choroidal detachment with marked hypotony developed in both eyes; with 1 percent brinzolamide it only occurred in the OS. The IOP raised and the choroidal detachment resolved completely after discontinuation of the medications. The dilemma was finally solved through repeat needling with subconjunctival 5-FU injections.

Variação da pressão intraocular após teste submáximo de força no treinamento resistido / Intraocular pressure variation after submaximal strength test in resistance training

OBJETIVO: Verificar a variação da pressão intraocular (PIO) decorrente da aplicação do teste de predição para uma repetição máxima (1RM). MÉTODOS: Foram avaliados em estudo observacional 145 calouros (22,04 ± 4,17 anos; de ambos os sexos) do curso de Educação Física da Escola Superior de Educação Física de Jundiaí (ESEFJ). Os critérios de exclusão foram: opacidade de meios, alteração de globo ocular ou ausência de globo ocular. Todos os participantes assinaram o Termo de Consentimento Livre e Esclarecido. A avaliação da PIO foi determinada por duas medidas consecutivas com o tonômetro de Perkins: i) pré-teste: antes do teste de 1RM e ii) pós-teste: logo após a realização do teste. O teste de 1RM consistiu em predizer o valor de uma repetição máxima através de repetições até a fadiga. Foram utilizados os seguintes exercícios resistidos: supino, pulley dorsal, desenvolvimento, rosca direta e leg press 45º. Como procedimento estatístico foi empregado o teste "t" de Student pareado. RESULTADOS: Ocorreu redução da PIO após a realização do teste de predição de 1RM: 13,48 ± 3,32 vs.10,20 ± 3,72 mmHg (p<0,001) olho direito e 13,13 ± 3,96 vs.9,74 ± 3,33 mmHg (p<0,001) olho esquerdo. CONCLUSÃO: Foi verificada redução da PIO após a realização de teste de predição de 1RM em universitários.

PURPOSE: To verify the intraocular pressure (IOP) after sub-maximal strength test. METHODS: 145 Physical Education freshmen (22.04 ± 4.17 years old; female and male) from Superior Physical Education School of Jundiaí (ESEFJ) were evaluated in an observacional study. The exclusion criteria were: media opacity and eyeball absence or changes. All subjects agreed to take part in this research and signed up the Informed Consent. IOP was measured by Perkins tonometer: i) pretest: just before the submaximal strength test performance and ii) post-test: immediately after the strength test. The strength test consisted in the one-repetition-maximum-assessment through repetition until fatigue. Resistance training exercises such as bench press, pulley dorsal high, shoulder press, arm curl and leg press 45º were performed. Statistical analyses were obtained through paired Student's "t" test. RESULTS: Decrease of IOP was observed after the strength test: 13.48 ± 3.32 vs.10.20 ± 3.72 (p<0.001) in the right eye and 13.13 ± 3.96 vs.9.74 ± 3.33 (p<0.001) in the left eye. CONCLUSION: IOP showed relevant decrease after submaximal strength test performance in college students.

Clinical obsrevation on early postoperative intraocular hypotension and ciliary deatchment after vitrectomy / 中华眼底病杂志

Objective To observe the incidence of ciliary detachment and its relationship with intraocular hypotension soon after vitrectomy.Methods A total of 46 eyes of 46 patients who underwent vitrectomy were examined by ultrasound biomicroscope (UBM).The patients were divided into three groups according to different tamponade: gas group (11 eyes),silicone oil group (8 eyes) and balanced saline solution (BSS) group (27 eyes).Basing on the postoperative intraocular pressure (IOP),the patients were divided into two groups: IOP<10 mm Hg (25 eyes) and IOP≥10 mm Hg (21 eyes).UBM was applied to determine the tomographic features of the ciliary body 3 days after the surgery.IOP were monitored by non-contact tonometer daily after the surgery.The eyes with ciliary detachment were then examined once a week till the ciliary detachment reattached.The follow-up period was from 14 to 35 days.Results After vitrectomy,ciliary detachment was observed in 20 eyes of 46 eyes (43.5%),The incidence of ciliary detachment was 27.3% in gas group,25.0% in silicone oil group,and 55.6% in BSS group.The average IOP in eyes with ciliary detachment [(6.47±4.49) mm Hg (1 mm Hg=0.133 kPa)] was significantly lower than that in the eyes without ciliary detaehmen [(15.61±7.72) mm Hg] (t=8.031,P<0.001).The incidence of ciliary detachment was higher in eyes with postoperative IOP <10 mm Hg (68.0%) than that in the eyes with postoperative IOP≥10 mm Hg (14.3%) (χ2=15.60,P<0.001).All eyes with postoperative ciliary detachment got spontaneous reattaehment within 30 days after the surgery except that one eye had optic disc edema due to severe intraocular hypotension.Conelusions Early postoperative ciliary detachment is a common complication after vitrectomy.Eyes filled with BSS have the highest incidence of postoperative ciliary detachment.Most of the patients with ciliary detachment may get spontaneous reattahment within 30 days after the surgery.

Detecção de maculopatia hipotônica subclínica pelo OCT III após cirurgia filtrante / Detection of subclinical hypotony maculopathy with OCT III after filtration surgery

OBJETIVO: Detectar possíveis sinais de maculopatia hipotônica subclínica por meio da OCT III em pacientes submetidos à cirurgia filtrante. MÉTODOS: Pacientes que realizaram procedimento cirúrgico filtrante com pressão intra-ocular menor que 9 mmHg submeteram-se ao exame OCT III. RESULTADOS: Sete (87,50 por cento) pacientes apresentaram diagnóstico prévio de glaucoma crônico simples e 1 (12,50 por cento) de glaucoma agudo de ângulo fechado. Apenas duas pacientes (25,00 por cento) apresentaram maculopatia hipotônica detectada pela OCT III. CONCLUSÃO: A OCT III parece ser um bom método diagnóstico de maculopatia hipotônica subclínica em pacientes submetidos à cirurgia filtrante convencional.

PURPOSE: To detect nondiagnostic hypotony maculopathy by OCT III after filtration surgery. METHODS: After surgery, patients with intraocular pressure less than 9 mmHg were submitted to OCT III examination. RESULTS: Seven (87.50 percent) patients with previous diagnosis of open angle glaucoma and one (12.50 percent) of them with acute angle closure glaucoma. Two patients (25.00 percent) presented hypotony maculopathy on OCT III examination. CONCLUSION: OCT III examination seems to be a good diagnostic method to detect subclinical hypotony maculopathy after filtration surgery.

An ivestigation on pathogenesis of chronic hypotony following anterior proliferative vitreoretinopathy / 中华眼底病杂志

Objective To investigate the occurrence, progress and conversion of hypotony in anterior proliferative vitreoretinopathy (aPVR), and to provide knowledge about how to prevent and treat it. Methods Animal models of chronic hypotony by aPVR were made with cultured homologous dermal fibroblasts on pigmented rabbits. The intraocular pressure (IOP) and ultrasound biomicroscopy(UBM) examination were taken preoperatively and on days 7,14, 28 and 56 postoperatively. Rabbits were killed on days 14, 28 or 56 postoperatively, prepared for histology and ultrastructure examination. Results The average IOP of experimental group was lower than that of control group on days 7,14,28 and 56 significantly (P