Early postoperative hypotony and ciliochoroidal detachment after microincision vitrectomy surgery

To determine the relationship between a ciliochoroidal detachment and intraocular pressure (IOP) after microincision vitrectomy surgery (MIVS).

Prospective, consecutive, observational case series.

Thirty eyes of 30 patients with an epiretinal membrane that underwent MIVS were prospectively studied. The intraocular pressure (IOP) was measured before 3-port MIVS, and at 1 minute, 1 and 3 hours, and at 1 day postoperatively. All of the 90 sclerotomies were examined by swept source optical coherence tomography to assess the wound and presence of a ciliochoroidal detachment at 3 hours and at 1 day postoperatively. The mean IOP and closure rate of the sclerotomies were compared between eyes with and without a ciliochoroidal detachment. The correlation between the presence of ciliochoroidal detachment and postoperative IOP was determined.

The incidence of ciliochoroidal detachment was 63.3% (19 eyes) during the 1-day observation period. The mean postoperative IOPs were significantly lower than the preoperative IOPs in eyes with a ciliochoroidal detachment (P < .05). The mean postoperative IOPs were significantly higher in eyes without a ciliochoroidal detachment than in eyes with a ciliochoroidal detachment (P < .05). The incidence of open sclerotomies was significantly higher in eyes with a ciliochoroidal detachment than in eyes without a ciliochoroidal detachment at 3 hours postoperatively (P = .03).

A shallow ciliochoroidal detachment develops in 63.3% of eyes after MIVS. Hypotony at the early postoperative period may be a risk factor for a ciliochoroidal detachment.