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Thomas Mendel, Karen M Joos, Jeffrey Kammer, Rachel W Kuchtey, Edward Cherney, Stephen J Kim; Prospective Retinal and Optic Nerve Vitrectomy Evaluation (PROVE) Study – Five-Year Findings. Invest. Ophthalmol. Vis. Sci. 2018;59(9):4428. doi: https://doi.org/.
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© ARVO (1962-2015); The Authors (2016-present)
To report 5-year findings of the Prospective Retinal and Optic Nerve Vitrectomy Evaluation (PROVE) Study
A 5-year, prospective, observational study of potential glaucomatous impact of vitrectomy was completed with 40 participants undergoing elective unilateral pars plana vitrectomy for epiretinal membrane, macular hole, or vitreous opacities. Participants were evaluated by a fellowship-trained glaucoma specialist for baseline measurements of visual acuity (VA), intraocular pressure (IOP), gonioscopy, central corneal thickness, and cup-to-disc ratio. They then underwent vitrectomy and were evaluated at 3 months and then annually thereafter.
32 of 40 enrolled patients (80%) completed 5 year of follow-up. Mean VA improved 3 lines in study eyes from baseline 20/50-1 to 20/25 (P = 0.001) but not to the level of fellow eyes 20/20-1 (P = 0.004). Relative to their baseline measurements at the start of the trial, mean IOP for pseudophakic eyes undergoing vitrectomy increased 3.3 mmHg when compared to phakic eyes undergoing vitrectomy over five years (P = 0.005). Angles remained open, and there were no significant changes after 5 years in central corneal thickness (P = 0.109) or cup-to-disc ratio (P = 0.799).
Five years after unilateral vitrectomy, VA improved 3 lines to within 1 line of fellow eye that did not undergo vitrectomy. Pseudophakic vitrectomy eyes demonstrated a rise in IOP of 3.3 mmHg when compared to phakic vitrectomy eyes over 5 years, similar to the primate work developed by Siegfried, et al. (IOVS 2017), in which partial pressure of oxygen significantly increased in the posterior chamber, around the intraocular lens, and the angle.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.
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