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Milad Hakimbashi, Kourous Rezaei; Rate of Elevated Intraocular Pressure Post Primary Vitrectomy Surgery. Invest. Ophthalmol. Vis. Sci. 2013;54(15):5802.
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To evaluate the rate of immediate post-operative intraocular pressure (IOP) elevation in patients who have undergone primary vitrectomy surgery.
Retrospective chart review of primary vitrectomies performed between 1/2010-10/2012 in a multi-surgeon retina practice. Patients with previous history of glaucoma, vitreo-retinal surgery, combination of vitrectomy and scleral buckling procedure, or trauma were excluded. IOP of 26 mmHg or above within the first week after surgery was considered elevated IOP.
Charts of 138 patients were reviewed and 102 eyes were included in the study. 10 eyes of 10 patients experienced IOP elevation within the first week after surgery. The average age of these patients was 65 years. 6 eyes were pseudophakic. The pre-operative diagnosis for surgery was retinal detachment (3 eyes), vitreous hemorrhage (3 eyes), epiretinal membrane (2 eyes), and macular hole (2 eyes). One eye had undergone 20-gauge vitrectomy surgery and rest had undergone 23-gauge vitrectomy surgery. 5 eyes required intraocular non-expansile gas tamponade (4 with C3F8, and 1 with SF6). None of the eyes had history of previous steroid exposure. The average post-op IOP was 32 mmHg with a range of 27-42 mmHg. All patients required topical pressure reducing drops. 2 patients required additional oral dorzolamide to lower the IOP. The average duration of the IOP elevation was 11.2 days with a range of 1-30 days. The patients were followed for an average of 13 months. 2 eyes were referred to glaucoma specialists for further management and required long term topical pressure reducing drops.
The rate of immediate IOP elevation post vitrectomy surgery in patients with no previous history of glaucoma or retinal surgery was 9.8%. In all patients the IOP elevation was treated with topical or oral therapy and no glaucoma surgery was necessary. In most patients the IOP increase was transient and only 2 patients were ultimately diagnosed with glaucoma and needed long term topical treatment. Intraocular pressure needs to be monitored post vitrectomy surgery.
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