Postural IOP elevation in Face-Down position in vitrectomized eyes: A Time-Related glaucoma risk indicator

To investigate posture-related intraocular pressure (IOP) fluctuations in eyes following vitrectomy.

This study included 54 patients (108 eyes) who had undergone unilateral vitrectomy for rhegmatogenous retinal detachment (RRD), with the fellow eye unaffected. IOP was measured after maintaining each posture for 10 min: sitting, supine, lateral decubitus position (LDP) with the healthy eye dependent, LDP with the operated eye dependent, and face-down. A linear mixed model was used to assess the effect of vitrectomy on IOP across different postures.

Vitrectomized eyes demonstrated significantly higher IOP in the face-down position compared to their healthy contralateral eyes ([Formula: see text] = 0.91 mmHg, 95% confidence interval [CI]: 0.26, 1.57; P = 0.013). IOP fluctuations between the sitting and face-down positions were also more pronounced in vitrectomized eyes ([Formula: see text]= 4.67%, 95% [CI]: 1.76, 7.58; P = 0.002). Subgroup analysis revealed that these differences were significant only in patients more than 6 months post-vitrectomy; no significant Changes were observed in those within 6 months of surgery. In addition, a longer axial length was independently associated with elevated face-down IOP.

Vitrectomized eyes are more prone to posture-related IOP elevation, especially in the face-down position and after six months postoperatively. This highlights the need for long-term IOP monitoring in these patients.