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H. Yang, K. Park, K. Park; Comparison of Intraocular Pressure Changes After Pars Plana Vitrectomy Combined With or Without Simultaneous Phacoemulsification and Intraocular Lens Insertion. Invest. Ophthalmol. Vis. Sci. 2007;48(13):1073.
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To compare the postoperative intraocular pressure changes after pars plana vitrectomy combined with or without simultaneous phacoemulsification and intraocular acrylic foldable lens insertion.
We performed a retrospective study of patients who underwent uneventful 20 Gauge pars plana vitrectomy combined with or without simultaneous phacoemulsification and intraocular lens implantation from October 2003 to October 2005. Patients with underlying disease, previous history of ocular injury, or who had intraoperative procedures prone to elevate intraocular pressure (IOP) were excluded. IOP and the number of glaucoma medication were reviewed in the preoperative and postoperative 1, 2, 3 days, 1, 3 weeks, and 1, 3 months period. Intraocular pressure changes after pars plana vitrectomy with (Group A) or without (Group B) simultaneous phacoemulsification and intraocular acrylic foldable lens insertion was evaluated.
There were 85 eyes of 85 patients in the vitrectomy only group (A), and 27 eyes of 27 patients in the combined phacovitrectomy group (B). The two most common diagnosis were diabetic retinopathy (60.7%) and branched retinal vein occlusion (19.6%) associated with tractional retinal detachment or vitreous hemorrhage. The mean age at the time of operation was 53.7±11.4 years (A) and 66.5±7.3 years (B) which were significantly different between both groups. Preoperative mean IOP (13.9±2.9 mmHg (A), 12.5±2.1 mmHg(B)) were significantly different between both groups. The mean IOPs on postoperative date (POD) 1, 2, 3 days were significantly higher than the preoperative value in both groups. The mean IOPs on POD 1, 2, 3 months were significantly lower than the preoperative value in both groups. The absolute amount of mean IOP rise (mmHg) (P=0.03, P=0.04) and the percentage of increase (%) (P=0.02, P=0.04), in comparison to the preoperative value, was significantly higher in the combined group (B) than the vitrectomy only group (A) on POD day 1 and day 2. The number of antiglaucoma medication were not significantly different between the two groups at all periods.
Vitrectomy combined with phacoemculsification surgery may have more risk of developing transient IOP increase in the early postoperative period in comparison to vitrectomy performed without phacoemulsification.
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