Novel Surgical Intervention To Manage Ocular Hypotension

Published 2022 - 40th Congress of the ESCRS

Reference: FPS12.07 | Type: Free paper | DOI: 10.82333/0pb7-kk94

Authors: Ziyad Alharbi* ¹ , Omneya M Abd Al-Rahman ² , Alejandra E Rodriguez ³ , Saad Abdulrahman J Al Amri ⁴ , Jorge L Alio ²

¹Al Nakheel Medical Center,Riyadh,Saudi Arabia;Cornea, Cataract &amp; Refractive Surgery Unit,VISSUM (Miranza Group),Alicante,Spain;School of Medicine,Miguel Hernandez University,Alicante,Spain, ²Cornea, Cataract &amp; Refractive Surgery Unit,VISSUM (Miranza Group),Alicante,Spain;School of Medicine,Miguel Hernandez University,Alicante,Spain, ³Research &amp; Development Laboratory,VISSUM (Miranza Group),Alicante,Spain;School of Medicine,Miguel Hernandez University,Alicante,Spain, ⁴Cornea, Cataract &amp; Refractive Surgery Unit,VISSUM (Miranza Group),Alicante,Spain;School of Medicine,Miguel Hernandez University,Alicante,Spain;Department of Ophthalmology,Prince Sultan Medical Military City (PSMMC),Riyadh,Saudi Arabia

Purpose

To present evidence for the efficacy and clinical improvement of extreme ocular hypotony by intracameral injection of autologous Platelet-Rich Plasma (PRP).

Setting

This novel surgical intervention was performed in VISSUM Grupo Miranza, Miguel Hernandez University, Alicante, Spain.

Methods

Eye PRP is prepared by first drawing blood from the patient and then undergoing a one-step centrifugation process before harvesting the plasma. 7 cases presented to us with chronic & extreme decrease of intraocular pressure unresponsive to medical & surgical intervention. The etiologies varied; one with Axenfield Rieger’s syndrome glaucoma, another had corneal perforation, a child with chronic juvenile uveitis, two cases with glaucoma drainage valves, one case had underwent numerous anterior segment reconstruction, and lastly a marfan syndrome patient with leaking scleral flap. All cases received isolated injections of 0.3-0.7 cc of autologous PRP in the anterior chamber as the final treatment modality.

Results

Intraocular pressure measurements after the injection improved to reach normal levels. Two patients underwent YAG laser 2 weeks after injection to dissolve the remnants of clotted Eye-PRP in the anterior chamber. Recovery of normal pressure varied from immediate to 1 month after intervention. One patient needed venting. Pressure remained stable along the full follow-up period of at least 6 months ranging to two years. No related complications were observed in the early or late stages of the follow-up in addition to resolution of the hypotony-associated corneal and macula edema.

Conclusions

Intracameral PRP injection was an effective, rapid and safe procedure for the treatment of severe chronic ocular hypotony secondary to a variety of causes without any apparent associated complication.