June 2017
Volume 58, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2017
Late-onset Ocular Hypertension after Pars Plana Vitrectomy: Five-Year Results of a Multicenter Chart-Review Study
Author Affiliations & Notes
  • Teresio Avitabile
    Eye Clinic, University of Catania, Catania, Italy, Catania, Italy
  • Caterina Gagliano
    Eye Clinic, University of Catania, Catania, Italy, Catania, Italy
  • Antonio Longo
    Eye Clinic, University of Catania, Catania, Italy, Catania, Italy
  • Cesare Mariotti
    Università Politecnica delle Marche, Ancona, Italy
  • Francesco Boscia
    Universita degli studi di Sassari, Sassari, Italy
  • Vincenza Bonfiglio
    Eye Clinic, University of Catania, Catania, Italy, Catania, Italy
  • Andrea Russo
    Eye Clinic, University of Catania, Catania, Italy, Catania, Italy
  • Matteo Roberto Fallico
    Eye Clinic, University of Catania, Catania, Italy, Catania, Italy
  • Guglielmo Parisi
    Eye Clinic, University of Catania, Catania, Italy, Catania, Italy
  • Michele Reibaldi
    Eye Clinic, University of Catania, Catania, Italy, Catania, Italy
  • Footnotes
    Commercial Relationships   Teresio Avitabile, None; Caterina Gagliano, None; Antonio Longo, None; Cesare Mariotti, None; Francesco Boscia, None; Vincenza Bonfiglio, None; Andrea Russo, None; Matteo Fallico, None; Guglielmo Parisi, None; Michele Reibaldi, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science June 2017, Vol.58, 3407. doi:
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      Teresio Avitabile, Caterina Gagliano, Antonio Longo, Cesare Mariotti, Francesco Boscia, Vincenza Bonfiglio, Andrea Russo, Matteo Roberto Fallico, Guglielmo Parisi, Michele Reibaldi; Late-onset Ocular Hypertension after Pars Plana Vitrectomy: Five-Year Results of a Multicenter Chart-Review Study. Invest. Ophthalmol. Vis. Sci. 2017;58(8):3407.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : Purpose: To determine the incidence and risk factors of late-onset ocular hypertension after vitrectomy.

Methods : Methods: In this retrospective multicenter cohort study all consecutive patients who underwent primary vitrectomy with at least 6 months, from January 2010 to December 2015, at 5 tertiary vitreoretinal centers in Italy were enrolled. Enrolled eyes were divided into 2 groups on the basis of presence of late-onset ocular hypertension after vitrectomy, determined by all of the following criteria: (1) IOP > 21 mmHg detected more than 2 months postoperatively on at least 2 separate visits; (2) an increase in IOP > 4 mmHg above the fellow eye; all eyes that developed late-onset ocular hypertension were identified as the late-onset ocular hypertension group. All other eyes that underwent vitrectomy in the same period, without late-onset ocular hypertension, were considered the control group. Patient demographics, systemic, ophthalmic, operative and postoperative data were drawn from the electronic medical records.

Results : Results: From a total of 6048 vitrectomy procedures, 294 cases of late-onset ocular hypertension (4.9%) were identified in the eyes that underwent vitrectomy, and 116 eyes in the fellow eye (1.9%). Multivariable logistic regression showed that significant risk factors for developing late-onset ocular hypertension included intraoperative triamcinolone use (odds ratio [OR], 7.78; P < 0.001), longer axial length (OR, 1.55; P = 0.023), preoperative higher IOP (OR, 1.81; P = 0.003), and pseudophakic/aphakic status (OR, 2.04; P < 0.001).
Decision-tree analysis showed that the stronger predictor of late-onset ocular hypertension was intraoperative triamcinolone use (P < 0.001).
Secondary predictors were a preoperative IOP more than 15 mmHg (P < 0.001) in eyes that use triamcinolone, and pseudophakic/aphakic status (P = 0.007) in eyes that not use triamcinolone. Finally, the third related classification variable was an axial length >24.9 mm in eyes with pseudophakic/aphakic status (P < 0.001) that not use triamcinolone.

Conclusions : Conclusions: Late-onset ocular hypertension occurs in 4.9% of vitrectomized eyes. The main risk factors are intraoperative use of triamcinolone and pseudophakic/aphakic status.

This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.

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