Abstract
Purpose :
To compare examination findings from postoperative day 0 (POD0) versus postoperative day 1 (POD1) in the same patient following various types of vitreoretinal surgery
Methods :
This study is a retrospective chart review of 90 patients who underwent various types of vitreoretinal surgery by two surgical retina specialists at two different institutions; due to similar training backgrounds, anesthesia and surgical approaches are very similar between both surgeons. Patients were seen on POD0 (mean 7 hours postoperative, range 4-10 hours) and again on POD1, and examination findings such as best-corrected visual acuity (BCVA), intraocular pressure (IOP), pain, view of the retina, and postoperative complications were recorded for each of the two days. Findings for POD0 and POD1 were compared and statistically analyzed using paired t-test, Chi-square test, and Fisher exact test. P<0.05 represented statistical significance.
Results :
90 patients were included in the study. Types of surgery varied widely, and included epiretinal membrane peels, tractional retinal detachment repair, macular hole repair, rhegmatogenous retinal detachment repair, and non-clearing vitreous hemorrhage surgery. Mean BCVA (logMAR) improved from 2.04 (SD 0.44) on POD0 to 1.83 (SD 0.65) on POD1 (P<.001). Mean IOP increased from 13.8 (SD 7.5) on POD0 to 17.5 (SD 7.0) mmHg on POD1 (P<.001). The development of elevated IOP (≥25 mmHg) on POD1 in patients who had an IOP≤25 mmHg on POD0 occurred in 9 patients (10.3%, range 25-34 mmHg; see Table 1). All of these patients had received C3F8 gas tamponade. On POD0, 16.1% of patients had hypotony (IOP≤5 mmHg) and 3.4% of patients required treatment for IOP≥30 mmHg compared to 5.7% and 4.6% of patients on POD1, respectively. There were no significant changes in pain or view of the retina between POD0 and POD1.
Conclusions :
While there are some differences in critical examination findings such as intraocular pressure between POD0 and POD1, the majority of these differences are values which fall in the normal physiologic range. The proportion of surgical retina patients developing significant postoperative complications on POD1 after a normal examination on POD0 is low, suggesting that evaluating a postoperative patient on day 0 may be an acceptable alternative to a traditional postoperative day 1 examination when the latter cannot be conducted due to patient constraints.
This is a 2020 ARVO Annual Meeting abstract.