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F. Okamoto, Y. Hasegawa, Y. Sugiura, Y. Okamoto, T. Oshika; Intraocular Pressure Elevation After Vitrectomy for Proliferative Diabetic Retinopathy. Invest. Ophthalmol. Vis. Sci. 2010;51(13):1742.
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To determine the incidence and risk factors of intraocular pressure (IOP) elevation in the immediate postoperative period after vitrectomy for proliferative diabetic retinopathy (PDR).
A prospective study was performed in 80 consecutive patients undergoing pars plana vitrectomy for PDR. 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, vitrectomy procedure (20G or 25G), operation time, use of expanding gas tamponade, number of laser photocoagulation, occurrence of postoperative fibrin formation, and severity of postoperative vitreous hemorrhage, to determine risk factors for IOP elevation.
In 20 patients (25%), IOP at 5-hour postoperatively was above 25 mmHg. Twenty-one patients (26%) showed 1-day IOP measurement above 25 mmHg. Standard 20G vitrectomy, use of expanding gas tamponade, and number of laser photocoagulation were significantly associated with IOP elevation 5 hours and 1 day after surgery. Stepwise multiple regression revealed that IOP at 5 hours postoperatively had a significant correlation with the use of expanding gas tamponade (p < 0.05), and that IOP at 1 day postoperatively had a significant correlation with the use of expanding gas tamponade (p < 0.0005) and the number of laser photocoagulation (p < 0.0005).
IOP elevation in the early postoperative period was not rare following vitrectomy for PDR. The risk factors of IOP elevation included use of gas tamponade and number of laser photocoagulation. Prophylactic treatment may be considered in eyes at a high-risk of IOP elevation.
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