Intraocular Pressure Change and Sustained Intraocular Pressure Elevation After Pars Plana Vitrectomy

Area of Science:

• Ophthalmology
• Surgical Outcomes
• Glaucoma Research

Background:

• Pars plana vitrectomy (PPV) is a common surgical procedure for various retinal conditions.
• Understanding post-operative intraocular pressure (IOP) changes is crucial for patient management.
• Uncomplicated PPV can still lead to significant IOP fluctuations.

Purpose of the Study:

• To determine the incidence of IOP changes and sustained IOP elevation (SIOPE) after uncomplicated PPV.
• To identify factors influencing IOP fluctuations post-PPV.
• To compare outcomes between 20-G and 23-G PPV instruments regarding IOP.

Main Methods:

• Retrospective analysis of 41 eyes from 41 patients undergoing PPV for epiretinal membrane, macular hole, or vitreomacular traction.
• Definition of SIOPE: IOP ≥21 mmHg or an increase of ≥6 mmHg from baseline on ≥2 visits, or new IOP-lowering medication.
• Comparison of IOP between vitrectomized and fellow eyes, and between 20-G and 23-G instrument groups.

Main Results:

• Mean postoperative IOP was significantly higher than preoperative IOP at 1, 6, and 12 months post-PPV.
• SIOPE occurred in 37% of vitrectomized eyes and 2% of fellow eyes.
• The 23-G instrument group showed significantly lower IOP on postoperative day 1 compared to the 20-G group.

Conclusions:

• Intraocular pressure can significantly increase after uncomplicated PPV compared to preoperative levels or the fellow eye.
• Preoperative IOP and SIOPE are important factors to consider alongside current IOP measurements when evaluating patients post-PPV.
• Surgical technique (20-G vs. 23-G) may influence early postoperative IOP levels.