Abstract
Purpose :
The current COVID-19 pandemic has emphasized the need for streamlining in person office visits while maintaining clinical outcomes and patient safety. Prior studies have shown that an intraocular pressure (IOP) increase at postoperative day one (POD1) is the primary clinical finding necessitating an unexpected management change after uncomplicated pars plana vitrectomy in asymptomatic patients. The purpose of this study was to evaluate whether a postoperative hour one (POH1) IOP measurement in the postoperative recovery area can predict a POD1 IOP elevation.
Methods :
Retrospective chart review was performed at an academic medical center of all cases of uncomplicated pars plana vitrectomy (with or without scleral buckle) for which POH1 IOP was measured between November 2019 and May 2020. The preoperative evaluation, operative report, and POD1 visit were reviewed. Relevant clinical characteristics were recorded including history of glaucoma or ocular hypertension, administration of intraoperative acetazolamide, POH1 IOP, POD1 IOP, and any additional unexpected management changes at the POD1 visit.
Results :
During the study period, 63 cases of 62 eyes had POH1 IOP evaluated. The most common indications for surgery were rhegmatogenous retinal detachment (61.9%) and macular hole repair (25.4%) After excluding eyes with a history of glaucoma or ocular hypertension, 5 patients had a POD1 IOP measurements over 30mmHg. All of these eyes had a POH1 IOP measurement over 20 mm Hg. No other significant unexpected management changes were prescribed at the POD1 timepoint in asymptomatic eyes.
Conclusions :
In non-glaucomatous eyes, POHR1 IOP measurements provide a promising tool to predict POD1 IOP elevations that would necessitate changes in management. As a result, POHR1 IOP data may help us streamline postoperative care for asymptomatic patients after uncomplicated vitreoretinal surgery during the COVID-19 pandemic.
This is a 2021 ARVO Annual Meeting abstract.