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Year : 1983  |  Volume : 31  |  Issue : 6  |  Page : 769-770

Inducing pre-operative hypotony for intra ocular surgery

C. B.M. Ophthalmic Institute, Little Flower Hospital, Angamally-Kerala, India

Correspondence Address:
S Tony Fernandez
C.B.M. Ophthalmic Institute, Little Flower Hospital, Angamally, Kerala
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Source of Support: None, Conflict of Interest: None

PMID: 6676263

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How to cite this article:
Fernandez S T, Thomas J. Inducing pre-operative hypotony for intra ocular surgery. Indian J Ophthalmol 1983;31:769-70

How to cite this URL:
Fernandez S T, Thomas J. Inducing pre-operative hypotony for intra ocular surgery. Indian J Ophthalmol [serial online] 1983 [cited 2023 Dec 10];31:769-70. Available from: https://journals.lww.com/ijo/pages/default.aspx/text.asp?1983/31/6/769/29321

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Table 1

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Table 1

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Introducting hypotony for intra ocular surgery has become the essential step for any intra ocular surgery especially for cataract ex­traction and for intra ocular lens implant. Low tension will avoid loss of vitreaous during surgery and retain air bubble in the eye, help­ing to introduce the intra ocular lens without damaging the ecdothelium. General methods like I.V.Manitol, Diamox etc. were used sys­temically to reduce the tension. Other local measures described for reducing intra ocular tension are :­

1. Finger Pressure Method

2. Paediatric B.P.Cuff Method

Aim of the Study: Our aim is to introduce a new and convenient method of inducing pre­operative hypotony. The method was intro­duced to us by Prof. V.Muller of West Ger­many. The effective pressure over the globe when measured was found to be about 550 gms. After retrobulbar and facial block, the weight is placed over the eye ball of the patient over an eye pad.

This method is compared with Finger Pres­sure Method:

1. To study the rapidity of the reduction of the tension in various groups.

2. To study the operative and post operative complications if any.


200 patients on whom routine cataract surgery or intra ocular lens implant surgery was done were subject to the study. In 100 cases Finger Pressure Method was used and in 100 cases Balanced Weight Method used.

1. Tension was noted after retrobulbar in­jection was given.

2. Tension was noted 5 minutes after Finger Pressure Method or Balaced Weight Method.

3. 7 minutes later tension was again re­peated and noted down.

Tension was taken with Schiotz Tonometer which was previously sterilized in hot air sterilizer. In between, spirit was user to clear the base.

  Observations Top

Average reduction of tension in these cases was noted as follows:­

Complications: There were hardly any sig­nificant complications. Slight subluxation of lenses was noted on the, table in 2 cases in each group but did not give rise to any complica­tions on extraction.

Vitreous Loss: In 2 cases in each group fluid­vitreous loss was noted. In none of the cases normal vitreous loss were noted.

Post Operative Complications Noted: In one

case a Central Vein Thrombosis was noted. We are not very sure whether this had occured before the operation or during the operation.

The Points Noted Are As Follows:­

1. After 5 minutes reduction of tension in both these methods was compartevely low to undertake surgery.

2. Older patients especially those above 55 - 65 years showed more reduction in tension than younger patients.

3. After 2 more minutes of applying the weight, the reduction was more dramatic. In some cases the tension was so low, that it could not be recorded.

Advantage of Balanced Weight Method:

1. Convenient and easy to apply as com­pared to finger pressure or paediatric cuff method.

2. Time of application was much less as com­pared to paediatric cuff method.

3. The balanced weight method was labour saving method as compared to finger pressure method, as the doctor does'nt have to attend to the patient after applying the balanced weight.

  Summary Top

A new and convenient method of inducting pre-operative hypotony. The redution of ten­sion with the balanced weight method is de­scribed and in both the methods was compara­ble but the balanced weight method was more convenient in application. Old aged people showed rapid reduction in tension as com­pared to younger age group. Vitreous loss was minimal. In 2 cases in each group, slight sublu­xation of the hypermature lenses occured. Therefore care should be taken in applying this methods in hypermature cataract.


  [Table - 1], [Table - 2], [Table - 3]


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