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H. Watanabe, F. Okamoto, Y. Hasegawa, Y. Sugiura, Y. Okamoto, T. Oshika; Intraocular Pressure Elevation After Vitrectomy for Rhegmatogenous Retinal Detachment. Invest. Ophthalmol. Vis. Sci. 2010;51(13):1744.
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To determine the incidence and risk factors of intraocular pressure (IOP) elevation on the first postoperative day after vitrectomy for rhegmatogenous retinal detachment (RD).
We included 34 eyes of 34 consecutive patients with RD undergoing standard 20-gauge pars plana vitrectomy. There were 23 males and 11 females, and their age averaged 56.1 ± 9.5 years (mean ± SD). 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, operation time, number of laser photocoagulation, development of postoperative vitreous hemorrhage, occurrence of postoperative fibrin formation, severity of postoperative vitreous hemorrhage, circumferential dimension of retinal tears, area of detachment, duration of disease, and macular involvement, to determine risk factors for IOP elevation.
IOP elevation(> 25 mmHg) was found in 5 eyes (14.7%) and 13 eyes(38.2%) at 5 hours and 1 day postoperatively, respectively. Of these 13 eyes with elevated IOP at 1 day after surgery, IOP elevation at 5 hours postoperatively was found in 2 eyes. Circumferential dimension of retinal tears and duration of disease were significantly associated with IOP elevation 5 hours after surgery. IOP elevations 1 day after surgery also were significantly associated with circumferential dimension of retinal tears and duration of disease. The other factors were not associated with IOP elevation at 5 hours and/or 1 day postoperatively.
IOP elevation in the early postoperative period is common following vitrectomy for RRD, occurring in 15% and 38% of eyes at 5 hours and 1 day postoperatively, respectively. The risk factors of IOP elevation were circumferential dimension of retinal tears and duration of detachment. Prophylactic treatment may be considered in eyes at a high-risk of IOP elevation.
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