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Irene M Rusu, Kelley J Bohm, John T Pena, Robison Vernon Paul Chan, Szilard Kiss, Donald J D'Amico, Anton Orlin; Long term complications of pars plana vitrectomy and the effect on intraocular pressure and the optic nerve. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):5102. doi: https://doi.org/.
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Purpose: To assess the effect of epiretinal membranes and pars plana vitrectomy on intraocular pressure in patients undergoing pars plana vitrectomy and epiretinal membrane peeling.<br />
Methods: This is a cross-sectional retrospective study of 156 patients with epiretinal membranes undergoing pars plana vitrectomy and membrane peeling. Exclusion criteria included a history of ocular inﬂammation, endophthalmitis, ocular trauma, previous vitrectomy, gas or silicone oil insufﬂation, and chronic corticosteroid use (systemic, local, or topical). Eyes were analyzed for postoperative complications, use of glaucoma medications, diagnosis of glaucoma or ocular hypertension, and any subsequent treatments, including laser and surgery. Best-corrected visual acuity and intraocular pressure were recorded (Goldmann applanation or Tono-Pen) of both the study eye and the fellow eye at the time of the preoperative visit, post-operative visits, and at the ﬁnal recorded visit. Main outcome measures were development of OAG or ocular hypertension, increase in intraocular pressure (IOP) greater than 4 mm Hg, and change in IOP from baseline. A two-tailed Student’s t-test was used to analyze continuous variables. The fellow nonoperative eyes served as the matched control group.<br />
Results: A total of 31 patients met the inclusion criteria and had at least one year of follow up. IOP increased from an average preoperative baseline of 13.2 (SD 3.9) mm Hg to an average of 14.9 (SD 6.7) mm Hg (p=0.05) at post-operative month 1 and an average of 14.0 (SD 2.5) mm Hg (p=0.009) at the most recent follow-up visit (between 2-3 years). Two patients were diagnosed with glaucoma and five patients (16.1%) had an increase in IOP of at least 4 mm Hg from baseline during the follow up period. The average IOP in the fellow eye was statistically different from the study eye at the preoperative visit (p=0.04) but was not significantly different from the IOP in the operative eye at the post-operative month 1 visit (p=0.18) or the most recent follow-up visit (p=0.59). <br />
Conclusions: The IOP in eyes after pars plana vitrectomy and membrane peeling for epiretinal membrane was increased at the post-operative month 1 visit and remained increased two to three years post-surgery.<br />
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