Intraocular Thermodynamics During Vitreoretinal Surgery

To characterize intraocular temperature changes before, during, and after vitreoretinal surgery at predefined anatomic locations within the vitreous cavity.

This prospective, observational, longitudinal study included patients undergoing vitreoretinal surgery. Intraocular temperature was measured using a 29-gauge/3-cm MT needle connected to a BAT-12R Physitemp thermometer at standardized anatomic sites (anterior, middle, and posterior vitreous) and predefined surgical stages, including pre-, intra-, and post-vitrectomy, as well as before and after phacoemulsification.

Twenty eyes were included. At the start of surgery, mean anterior chamber and vitreous cavity temperatures were 28.69°C and 32.16°C, respectively. After phacoemulsification, vitreous temperature decreased by 3.01°C. During vitrectomy, intraocular temperature decreased across all measured regions compared with baseline pre-vitrectomy values (-1.5°C anterior, -2.2°C middle, and -1.8°C posterior vitreous). A posterior-to-anterior temperature gradient was observed, with higher baseline temperatures in the posterior vitreous.

Intraocular temperature varies dynamically during vitreoretinal surgery and is not uniformly distributed within the vitreous cavity. Intraoperative cooling and spatial temperature gradients suggest that intraocular thermodynamics may influence retinal physiology, fluidics behavior, and tamponade properties. These findings underscore the role of intraocular thermodynamics as a clinically relevant factor in vitreoretinal surgery.