Course of intraocular pressure after vitreoretinal surgery: is early postoperative intraocular pressure elevation predictable?

Abstract

Purpose: Assessment of intraocular pressure (IOP) after vitreoretinal surgery is important to ensure functionality of the eye. Incidences and risk factors for early postoperative IOP elevation were evaluated.

Methods: In a prospective case series of 210 vitreoretinal cases, IOP-lowering treatment was performed at IOP values of ≥30 mmHg. Differences in IOP elevation in relation to surgical procedures and tamponades were evaluated.

Results: Sixty-two patients required treatment (29.5%). Encircling bands were associated with a high risk for IOP elevation when combined with pars plana vitrectomy and gas tamponade (37.9%) or oil tamponade (50.0%). Panretinal laser photocoagulation in conjunction with oil tamponade for proliferative diabetic retinopathy traction retinal detachment (RD) resulted in the highest risk for IOP increases (83.3%). Intraocular pressure elevation in proliferative diabetic retinopathy traction RD often evolved 4 hours after vitreoretinal surgery compared with 8 hours to 12 hours after vitreoretinal surgery in rhegmatogenous RD. Silicone oil removals (7.1%) and external buckling procedures (0.0%) carried low risks for IOP increases.

Conclusion: Patients treated for proliferative diabetic retinopathy traction RD and for primary rhegmatogenous RD were at high risk for prolonged IOP elevation. These groups also required medical retreatment most often and should therefore be closely monitored. Care must be taken not to overlook delayed IOP elevations.