Department of Ophthalmology, Mayo Clinic, Rochester, Minnesota.
Department of Quantitative Health Sciences, Mayo Clinic, Jacksonville, Florida.
Ophthalmol Glaucoma. 2024 Jan-Feb;7(1):1-7. doi: 10.1016/j.ogla.2023.07.007. Epub 2023 Jul 22.
To investigate the in vivo effect of scleral buckle surgery on ocular biomechanics and aqueous humor dynamics.
Prospective observational cross-sectional study.
Nine patients with unilateral 360 degree encircling scleral buckles without vitrectomy for rhegmatogenous retinal detachments, between 3 and 39 months postoperative.
All measurements were performed in both eyes of all participants. Intraocular pressure (IOP) was measured in the seated and supine positions using pneumatonometry. Outflow facility was measured using 2-minute weighted pneumatonography. Ocular rigidity coefficient was determined from the Friedenwald equations based on the difference in IOP with and without a weighted tonometer tip. The percentage change in IOP upon transitioning from seated to supine was calculated. Measurements for buckled and nonbuckled eyes were compared using paired Student t test of means.
Sitting and supine IOP and percentage difference between the 2 positions; outflow facility; ocular rigidity coefficient.
Seated IOP was similar between buckled and nonbuckled eyes (16.1 ± 2.5 vs. 16.7 ± 2.7 mmHg; P = 0.5) whereas supine IOP was lower in buckled eyes compared with nonbuckled eyes (18.7 ± 2.6 vs. 21.3 ± 2.5 mmHg; P = 0.008). The percentage increase in IOP upon change in body position from seated to supine was greater in nonbuckled eyes (17.4 ± 9.4% vs. 27.6 ± 9.5%; P = 0.005). Ocular rigidity coefficient was lower in buckled (9.9 × 10 ± 1.4 × 10 μL) vs. nonbuckled eyes (14.4 × 10 ± 3.1 × 10 μL; P = 0.006). Outflow facility was not significantly different in buckled and nonbuckled eyes.
Scleral buckling decreases ocular rigidity but does not affect outflow facility. This change in ocular biomechanics likely results in the attenuated IOP change from seated to supine position. Decreased ocular rigidity may also reduce IOP fluctuations and potentially reduce the risk for glaucoma progression.
FINANCIAL DISCLOSURE(S): Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.
研究巩膜扣带术对眼生物力学和房水动力学的体内作用。
前瞻性观察性横断面研究。
9 例单侧 360 度环扎巩膜扣带术患者，无玻璃体切割术治疗孔源性视网膜脱离，术后 3 至 39 个月。
所有参与者的双眼均进行所有测量。采用气动眼压计测量坐位和仰卧位的眼压。使用 2 分钟加权气动眼压描记术测量流出道功能。根据有无带砝码眼压计尖端的眼压差值，用 Friedenwald 方程确定眼刚性系数。计算从坐姿过渡到仰卧位时眼压的百分比变化。使用配对学生 t 检验比较扣带眼和非扣带眼的测量值。
坐位和仰卧位眼压及 2 个位置的差值百分比；流出道功能；眼刚性系数。
扣带眼和非扣带眼坐位眼压相似（16.1±2.5 对 16.7±2.7mmHg；P=0.5），而仰卧位眼压扣带眼低于非扣带眼（18.7±2.6 对 21.3±2.5mmHg；P=0.008）。从坐位到仰卧位改变体位时，非扣带眼眼压升高百分比更大（17.4±9.4%对 27.6±9.5%；P=0.005）。扣带眼（9.9×10±1.4×10μL）的眼刚性系数低于非扣带眼（14.4×10±3.1×10μL；P=0.006）。扣带眼和非扣带眼的流出道功能无显著差异。
巩膜扣带术降低眼刚性，但不影响流出道功能。这种眼生物力学的变化可能导致从坐位到仰卧位眼压变化减弱。眼刚性降低也可能减少眼压波动，潜在降低青光眼进展风险。
本文结尾的脚注和披露中可能包含专有或商业披露信息。
