The role of day one postoperative review of intraocular pressure in modern vitrectomy surgery

Abstract

Day 1 review detected adverse events in 0.5% of study patients. No long-term complications were reported in the 22% of patients who received treatment for early postoperative IOP elevation. This observation has led to the removal of routine day 1 review from the surgical care pathway following routine uncomplicated vitrectomy at the study institution.

Incidence of Management Changes at the Postoperative Day One Visit After Pars Plana Vitrectomy for Retinal Detachment

“…While there have been a few studies evaluating the utility of a postoperative day one visit, additional evidence is needed. 2 , 3 , 4 However, there is interest in increasing postoperative visit efficiency. This interest is highlighted by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic.…”

“… 2 , 3 , 4 Due to advancements in surgical techniques, such as smaller gauge vitrectomy, adverse events following pars plana vitrectomy has decreased. 2 , 4 For example, elevated IOP on POD1 after 20-gauge vitrectomy was seen in 14.9% of patients. 5 However, elevated IOP on POD1 from a 23-gauge, 25-gauge, or 27-gauge vitrectomy occurred in only 3.9% of patients.…”

“… 6 , 7 , 8 , 9 The incidence of any postoperative adverse events at the POD1 timepoint has been reported as 0.5% with these newer, routinely utilized surgical platforms. 4 …”

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

“…Our study focused on a selected group of patients and reported an incidence of 6% day 1 postoperative IOP, without prophylactic treatment. Brennan et al 1 recently reported a 0.5% incidence of raised IOP on day 1 postvitrectomy and have justified omitting first day review of low-risk TSV procedures.…”

“…The issue of intraocular pressure (IOP) on day 1 post pars plana vitrectomy (PPV) is up for considerable debate. 1,2 Over 25 years ago, Han et al 3 reported a significant rise in IOP immediately following the procedure. It has been a common practice to assess the majority of such patients on day 1 postoperatively.…”