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Alexandre Matet, Virginie Martinet, Benjamin Wolff, Alexandre Bourhis, Sebastien Bonnel, Jose A. Sahel, Yannick Le Mer; Long-term Changes in Intraocular Pressure after Pars Plana Vitrectomy : a Retrospective Study. Invest. Ophthalmol. Vis. Sci. 2012;53(14):3787.
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To report data on long-term trends in intraocular pressure (IOP) and incidence of open angle glaucoma (OAG) following uncomplicated pars plana vitrectomy.
Of 516 patients who underwent pars plana vitrectomy for macular hole or epimacular membrane between January 2003 and December 2008, 175 patients who had at least 1 year of follow-up, did not have preexisting glaucoma and were not at risk for developing secondary glaucoma, were included. Main exclusion criteria were : more than one vitrectomy procedure, ocular trauma, chronic intraocular inflammation, retinal vascular disease, administration of intravitreal or chronic topical corticosteroids, high myopia, scleral buckle, or silicone oil tamponade. 152 healthy fellow eyes were used as control, and retrospective cohort analysis was performed. For each patient, final IOP was obtained by averaging the last two most recent measured IOP. The patients were separated into two groups, based on the use of gas tamponade. Outcomes were: incidence of OAG, increase in IOP of more than 3 mmHg.
Mean follow-up was 43 months (range, 16-79 months). In the vitrectomized eyes, mean baseline IOP was 14.0 mmHg, and mean final IOP was 14.3 mmHg. In the control eyes, mean baseline IOP was 14.3 mmHg and mean final IOP was 13.7 mmHg. Of the 175 vitrectomized eyes, 5.1% (n = 9) developed OAG, and 14.2% (n = 25) showed an IOP increase of more than 3mmHg, versus 4.6% (n = 7) and 13.1% (n = 20) in the 152 control eyes, respectively. These trends did not reach statistical significance. Group analysis of 91 patients who received gas tamponade did not demonstrate significant difference in rates of increased final IOP. Lens status was not associated with any significant change in IOP.
In this series, vitrectomy does not appear to increase the risk of open angle glaucoma. In a long-term perspective, tamponade by expansive intraocular gas is not associated with higher intraocular pressure following vitrectomy.
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