Risk Factors for Elevated Intraocular Pressure on First Day Postoperative Review Following Pars Plana Vitrectomy

Abstract

To assess the relationship between day one post-operative intra-ocular pressure and patient demographic information, lens status, tamponade medium (air, perfluoroethane, sulfur hexafluoride) and laser treatment. Methods: A prospective observational study of all patients undergoing pars plana vitrectomy by a single surgeon within one case study. All patients had intraocular pressure recorded one-day after surgery. None of the patients had postoperative antiglaucoma medications. All patients undergoing pars plana vitrectomy were previously pseudophakic or underwent combined surgery. Results: Out of a final cohort of 161 patients, 6% had raised IOP (defined as >30mmHg). A parsimonious regression model showed no strong correlation between raised IOP and type of gas tamponade (p=0.028 for C2F6, p=0.067 for SF6, air was the reference category), and a moderate association with number of laser burns (p=0.067). Conclusion: The use of gas tamponade, in particular C2F6, does not constitute justification for pre/post-operative anti-glaucoma prophylactic treatment. In addition we postulate that careful consideration should be given to the frequency of laser burns during PPV.

Comparison of Methods of Endotamponade Used During 23-Gauge Pars Plana Vitrectomy and the Risk of Raised Intraocular Pressure During 24-Month Follow-Up: A Retrospective Study of 196 Patients

“…Increased IOP is a common complication of vitrectomy during the early postoperative stage [1][2][3][4][5][6]. The risk factors for IOP include postoperative inflammation, the use of gaseous methods of endotamponade, excessive or poorly directed laser photocoagulation, and transient choroidal edema [1,[3][4][5][6][7][8]. Previous clinical studies have shown that up to half of the patients developed IOP within two weeks following vitrectomy for macular hole [2,4].…”

Assessment of the Effectiveness of Glaucoma Treatment Using MicroPulse Transscleral Cyclophotocoagulation in Patients with Glaucoma Who Have Previously Undergone Vitreoretinal Surgery

“…A significant, common complication of PPV is a repeated rise in IOP above the normal limit, i.e., 21 mmHg. The risk factors include, among others, postoperative infection, use of gas as endotamponade, excessive or incorrectly directed laser coagulation and transient cystoid macular edema [ 18 , 19 ].…”

“…Pars plana vitrectomy (PPV) is a surgical procedure that can be used to treat retinal and vitreous body diseases, such as retinal detachment, epiretinal membranes, macular holes, vitreoretinal traction, or hemorrhage into the vitreous chamber [15,16]. Common complications following PPV include an increase in IOP, which is predisposed by postoperative inflammation, the type of endotamponade used, and excessive or incorrectly directed laser coagulation [17][18][19][20]. Two types of transscleral cyclophotocoagulation (TSCPC), which are used to lower IOP after PPV, can be differentiated, namely traditional continuous-wave (CW-TSCPC) and, more recently, MicroPulse TSCPC (lP-TSCPC) (Iridex, Mountain View, CA, USA).…”