Osman Çekiç, M. Selim Kocabora, Kübra Þerefoðlu (Istanbul, Turkey)

Advantages:

To present data on the long-term intraocular pressure changes after vitrectomy.

Methods:

A retrospective observational study was undertaken of patients that underwent pars plana vitrectomy. The main outcome measure was final intraocular pressure (IOP) of the vitrectomized eye. Confounding cases were excluded.

Effectiveness / Safety:

A total of 41 eyes of 41 patients (17 male and 24 female, mean age: 67 years) that underwent pars plana vitrectomy for various retinal pathologies were included in the analysis. Patients underwent pars plana vitrectomy either by 20-gauge (n = 11) or 23 Gauge system (n = 30). In 5 of 41 patients, cataract surgery with phacoemulsification was also combined to pars plana vitrectomy. SF6 gas (n = 8), C3F8 gas (n = 5), air (n = 16) or balanced salt solution (n = 12) was used as intraocular tamponade. The mean follow-up time was 14 months (range, 6-24 months). At one year, average IOP in vitrectomized eyes was found to be significantly higher than at baseline (15.3 ± 3.2 mmHg [±SD] versus 16.8 ± 2.6 mmHg, P = 0.024). At the last follow-up, IOP of the operated eye was at least 4 mmHg higher than the fellow non-operated eye in 15 out of 41 patients (37%). IOP rise (> 21 mmHg) occurred starting from the first postoperative day in one patient, and at the first month in two patients. All three of them were phakic preoperatively. Their IOP was under control with topical glaucoma medications at the last follow-up.

Take home message:

There is an increased risk of late IOP elevation after vitrectomy. Patients must be observed closely for prolonged periods after surgery.