Anterior chamber paracentesis

Anterior chamber paracentesis (ACP) is a surgical procedure done to reduce intraocular pressure (IOP) of the eye. The procedure is used in management of glaucoma and uveitis. It is also used for clinical diagnosis of infectious uveitis.

Uses

Anterior chamber paracentesis is used in the management of acute angle closure glaucoma, and uveitis.[1][2] It can also prevent a raise in IOP after intravitreal injections.[3] Aqueous humor collected using anterior chamber paracentesis may be used for clinical diagnosis of infectious uveitis.[4]

Procedure

In this procedure aqueous humor from the anterior chamber of eyeball is drained out by using a tuberculin syringe, with or without a plunger attached to a hypodermic needle or a paracentesis incision.[1] Eye is anesthetized using proparacaine or tetracaine eye drops prior to ACP.[5] Paracentesis is performed through the clear cornea adjacent to the limbus.[5]

Complications

Pain, traumatic injuries of the iris, corneal abscess, inadvertent lens touch, occurrence of Anterior chamber fibrin, Intraocular hemorrhage, decompression retinopathy, hyphaema, ocular hypotension due to leakage and exogenous endophthalmitis are complication of ACP.[1][3][6] Traumatic cataract may occur secondary to lens trauma.[5]

References
  1. Cioboata, M; Anghelie, A; Chiotan, C; Liora, R; Serban, R; Cornăcel, C (2014). "Benefits of anterior chamber paracentesis in the management of glaucomatous emergencies". Journal of Medicine and Life. 7 (Spec Iss 2): 5–6. ISSN 1844-122X. PMC 4391354. PMID 25870663.
  2. Cheung, C. M. G.; Durrani, O. M.; Murray, P. I. (1 April 2004). "The safety of anterior chamber paracentesis in patients with uveitis". British Journal of Ophthalmology. 88 (4): 582–583. doi:10.1136/bjo.2003.027219. ISSN 0007-1161. PMC 1772115. PMID 15031183.
  3. Saxena, Sandeep; Lai, Timothy Y.; Koizumi, Hideki; Farah, Michel E.; Ferrara, Daniela; Pelayes, David; Sato, Tomohito; Meyer, Carsten H.; Murray, Timothy; Andrade, Gabriel; Chan, Clement K.; Grover, Sandeep; Farah, Michel E.; Fauser, Sascha; Ferrara, Daniela; Ferrara, Vincenco; Hiller, Roxane J.; Ichiyama, Yusuke; Inoue, Makoto; Garfella, Marisa Hernandez; Karimi, Saeed; Koizumi, Hideki; Koss, Michael; Lai, Timothy Y.; Liu, Fung; Meyer, Carsten H.; Muni, Rajeev; Murray, Timothy; Natarajan, Sundaram; Neri, Piergiorgio; Ohji, Masahito; Park, Dong Ho; Pelayes, David; Sabrosa, Nelson A.; Riemann, Christopher; Sakurada, Yoichi; Sato, Tomohito; Saxena, Sandeep; Takeuchi, Massaru; Yang, Sung Jae; Zhang, Han; Zhang, Yingnan (6 March 2019). "Anterior chamber paracentesis during intravitreal injections in observational trials: effectiveness and safety and effects". International Journal of Retina and Vitreous. 5 (1): 8. doi:10.1186/s40942-019-0157-z. ISSN 2056-9920. S2CID 76663934.
  4. Schaftenaar, E.; Lecuona, K. A.; Baarsma, G. S.; Meenken, C.; Verjans, G. M. G. M.; McIntyre, J. A.; Peters, R. P. H. (August 2015). "Anterior chamber paracentesis to improve diagnosis and treatment of infectious uveitis in South Africa". SAMJ: South African Medical Journal. 105 (8): 628–630. doi:10.7196/SAMJNEW.7816. ISSN 0256-9574. PMID 26449700.
  5. Hersh, Peter S. (2009). "Anterior chamber paracentesis". Ophthalmic surgical procedures (2nd ed.). New York: Thieme. ISBN 978-0-86577-980-8.
  6. Wertheim, M. S.; Connell, P. P.; Majid, M. A.; Dick, A. D. (June 2009). "The minim technique for diagnostic anterior chamber paracentesis". Eye. 23 (6): 1491. doi:10.1038/eye.2008.231. ISSN 1476-5454. PMID 18688263. S2CID 39054487.


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