Intraocular Pressure Elevation Is A Delayed-onset Complication After Successful Vitrectomy For Stages 4 And 5 Retinopathy Of Prematurity

Abstract

Purpose: : To determine the incidence and risk factors for delayed-onset intraocular pressure (IOP) elevations following vitrectomy for stages 4 and 5 retinopathy of prematurity (ROP). In addition, to determine the results of treating the IOP elevations.

Methods: : Fifty-five consecutive eyes with successful retinal reattachment and at least 24 months of follow-up after vitrectomy were studied. The ophthalmic examinations included slit-lamp biomicroscopy, wide-field digital retinal imaging, and IOP measurements. Eyes were classified into two groups; eyes with a postoperative IOP elevation to ≥21 mmHg, and eyes whose IOP was always <21 mmHg.

Results: : Eight eyes (14.5%) developed an IOP elevation to ≥21 mmHg from 2 to 4 (median: 2.5) months after the vitrectomy. In two of these eyes, the IOP was controlled with anti-glaucoma medications. In the other six eyes, trabeculotomy for eyes with open-angles and trabeculectomy or goniosynechialysis for eyes with closed-angles were performed. The IOPs were successfully controlled after an average of 1.5 glaucoma surgeries. Multivariate logistic-regression analyses identified that a young gestational age (OR=1.147, 95%CI 1.024-1.346) and lensectomy (OR=8.795, 95%CI 1.262-183.3) were significantly associated with the IOP elevation.

Conclusions: : Delayed-onset IOP elevation after vitrectomy for ROP occurs in 14.5% of the eyes, and it is significantly associated with a young gestational age and presence of lensectomy.

Keywords: retinopathy of prematurity • vitreoretinal surgery • intraocular pressure