Rise in intraocular pressure with elevator travel in post-vitrectomy patients

Area of Science:

• Ophthalmology
• Surgical Innovation
• Patient Safety

Background:

• Vitreoretinal surgery often involves gas tamponade to maintain retinal position.
• Post-operative monitoring is crucial, especially concerning intraocular pressure (IOP).
• The effect of rapid atmospheric pressure changes, like elevator travel, on IOP after surgery is not well-understood.

Purpose of the Study:

• To assess the impact of elevator travel on intraocular pressure (IOP) in patients post-vitreoretinal surgery.
• To compare IOP changes in patients with and without intraocular gas tamponade.
• To determine the safety implications of rapid altitude changes in the immediate post-operative period.

Main Methods:

• Prospective study involving 54 patients undergoing pars plana vitreoretinal surgery.
• Patients were divided into two groups: 27 with gas insertion and 27 without (controls).
• Intraocular pressure was measured pre- and post-elevator travel (4th to 12th floor) using a Tono-Pen AVIA.

Main Results:

• Patients with gas tamponade showed a statistically significant mean IOP increase of +1.39 mmHg after elevator travel.
• Patients without gas tamponade had a mean IOP change of -0.43 mmHg, which was not statistically significant.
• The difference in IOP change between the two groups was statistically significant (P < 0.0001).

Conclusions:

• Elevator travel causes a significant intraocular pressure rise in patients with intraocular gas tamponade immediately after vitreoretinal surgery.
• Patients without gas tamponade do not experience significant IOP changes with similar elevator travel.
• Further research is recommended to explore effects across wider altitude ranges and with different gases.