Purchase this article with an account.
K. Hiratsuka, F. Okamoto, Y. Hasegawa, Y. Sugiura, T. Oshika; Intraocular Pressure Elevation After Vitrectomy for Proliferative Diabetic Retinopathy. Invest. Ophthalmol. Vis. Sci. 2009;50(13):6059.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
To determine the incidence and risk factors of intraocular pressure (IOP) elevation on the first postoperative day after vitrectomy for proliferative diabetic retinopathy (PDR).
A prospective study was performed in 80 consecutive patients undergoing pars plana vitrectomy. IOP was measured before surgery, at the end of surgery, and at 5 hours and 1 day after surgery using Tonopen XL®. IOP at the end of surgery were adjusted to 15.0 ± 2.0 mmHg. Clinical data were collected, including age, sex, performance of combined cataract surgery, cutter size (20G or 25G), operation time, use of gas tamponade (20% SF6), number of laser photocoagulation, occurrence of postoperative fibrin formation, and the severity of postoperative vitreous hemorrhage, to determine risk factors for IOP elevation.
In 29 eyes (36.3%), IOP at 5 hours was above 22 mmHg. In 29 eyes (36.3%), IOP at postoperative day 1 was above 22 mmHg. Postoperative vitreous hemorrhage, use of gas tamponade, larger number of laser photocoagulation, and 20G vitrectomy were significantly associated with IOP elevation 5 hours after surgery. In addition, combined cataract surgery, use of gas tamponade, larger number of laser photocoagulation, and 20G vitrectomy were significantly associated with IOP elevation 1 day after surgery. Multiple regression analysis revealed that IOP at 5 hours postoperatively had a significant correlation with the use of gas tamponade (p < 0.05), and that IOP at 1 day postoperatively had a significant correlation with the use of gas tamponade (p < 0.0005) and the number of laser photocoagulation (p < 0.0005), whereas other explanatory variables were not relevant.
IOP elevation in the early postoperative period was not rare following vitrectomy for PDR. The risk factors of IOP elevation were use of gas tamponade and number of laser photocoagulation. Prophylactic treatment should be considered in eyes at a high-risk.
This PDF is available to Subscribers Only