Abstract
The efficacy and side effects of sulphur hexafluoride (SF6) in the reformation of the flat anterior chamber (AC) after standard trabeculectomies were studied. Ten patients with lenticulocorneal touch following trabeculectomy were enrolled. All had water-tight conjunctival wounds with overflowing fistulas. In 5, one to four surgical attempts to reform the AC were unsuccessful. Two to seven days after trabeculectomy, the AC was reformed by a single injection of SF6/air mixture (20–40%). Gas was injected through the limbus at 3 or 9 o'clock. The AC remained deep after absorption of the gas in 2–7 days. All patients had stromal oedema in the first 4 days. This resolved and specular microscopy did not show any abnormality. After a mean follow-up of 2.5 years, all had normal intraocular pressure, 3 with one topical antiglaucoma treatment. Three patients developed cataracts before and 3 after reformation of the AC. The latter 3 were not anterior capsular cataracts as induced by gases. SF6/air mixture (20–40%) is inert and kind to the cornea and, as it is absorbed in less than 7 days, it exerts minimal damage to the crystalline lens. It is effective in the reformation of flat ACs.
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Wilson MR, Yoshizumi MO, Lee DA, Martin W . Use of intraocular gas in flat anterior chamber after filtration surgery. Arch Ophthalmol 1988;106:1345.
Shin DH . Management of flat anterior chamber with hypotonia after glaucoma surgery. Glaucoma 1982;4:193–7.
Hill RA, Aminlari A, Sassani JW, Michalski M . Use of a symblepharon ring for treatment of over-filtration and leaking blebs after glaucoma filtration surgery. Ophthalmic Surg 1990;21:707–10.
Joiner DW, Liebmann JM, Ritch R . A modification of the use of the glaucoma tamponade shell. Ophthalmic Surg 1989;20:441–2.
Hanczy P, Mach AT . Detachment of the choroid after cataract extraction. Klin Oczna 1990;92:229–30.
Fourman S . Management of cornea-lens touch after filtering surgery for glaucoma. Ophthalmology 1990;97:424–8.
Franks WA, Hitchings RA . Intraocular gas injection in the treatment of cornea-lens touch and choroidal effusion following fistulising surgery. Ophthalmic Surg 1990;12:831–4.
Franks WA, Hitching RA . Injection of perfluoropro-pane gas to prevent hypotony in eyes undergoing tube implant surgery. Ophthalmology 1990;97:899–903.
Schulze F, Schmidtsdorf H . Damage to the corneal endothelium following exposure to sulfur hexafluoride gas. Klin Monatsbl Augenheilkd 1989;194:447–53.
Cairns JE . Trabeculectomy: preliminary report of a new method. Am J Ophthalmol 1968;5:673–9.
Ostberg A, Tornqvist G . Management of detachment of Descemet's membrane caused by injection of hyaluronic acid. Ophthalmic Surg 1989;20:885–6.
Maus M, Katz LJ . Choroidal detachment, flat anterior chamber and hypotony as complications of neodymium:YAG laser cyclophotocoagulation. Ophthalmology 1990;97:69–72.
Austin MW, Wishart PK . Reformation of anterior chamber following trabeculectomy. Ophthalmic Surg 1993;24:461–6.
Diddie KR, Smith RE . Intraocular gas injection in the pseudophakic patient. Am J Ophthalmol 1980;89:659–61.
Chang S . Intraocular gases. In: Glaser BM, Michels RG, editors. Retina, vol 3. CV Mosby, 1989:245–59.
Jacobs PM, Twomey JM, Leaver PK . Behaviour of intraocular gases. Eye 1988;2:660–3.
Lincoff H, Mardirossian J, Lincoff A, Liggett P, Iwamoto J, Jacobiee F . Intravitreal longevity of three perfluorocarbon gases. Arch Ophthalmol 1980;98:1610–11.
Barak A, Alhalel A, Kotas R, Melamed S . The protective effect of early intraoperative injection of viscoelastic material in trabeculectomy. Ophthalmic Surg 1992;23:206–9.
Lee DA, WUson MR, Yoshizumi MO, Hall M . The ocular effects of gases when injected into the anterior chamber of a rabbit eye. Arch Ophthalmol 1991;109:571–5.
Van Horn DL, Edelhauser HF, Aaberg TM, Pederson HJ . In vivo effects of air and sulphur hexafluoride gas on rabbit corneal endothelium. Invest Ophthalmo] 1972;11:1028–30.
Foulks GN, de Juan E, Hatchell DL, McAdoo T, Hardin J . The effect of perfluoropropane on the cornea in rabbits and cats. Arch Ophthalmol 1987;105:256–9.
Shin DH . Trabeculectomy. Int Ophthalmol Clin 1981;21:47–68.
Green K, Cheeks L, Stewart DA, Norman BC . Intraocular gas effects on corneal endothelial permeability. Lens Eye Toxic Res 1992;2:85–91.
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Beigi, B., O'Keefe, M., Algawi, K. et al. Sulphur hexafluoride in the treatment of flat anterior chamber following trabeculectomy. Eye 11, 672–676 (1997). https://doi.org/10.1038/eye.1997.175
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DOI: https://doi.org/10.1038/eye.1997.175