Abstract
BackgroundTo assess the relationship between different indications for trans pars plana vitrectomies (PPV’s) and the intraocular pressure (IOP), and the effect of multiple PPV’s on the IOP. We also examined whether there were differences in the number of IOP-lowering medications or surgeries before and after PPV.MethodsA retrospective study including all patients that underwent at least one PPV in the period from 2001 till 2014 at our clinic. Medical records of all patients were reviewed and clinically relevant data were entered in a database. Generalized estimating equations models for repeated measurements were used to examine the effect of the number of PPV’s on the IOP and on the risk of undergoing glaucoma surgery, for each of the indications for PPV.ResultsOf 1072 PPV’s 447 eyes fulfilled the inclusion criteria. The IOP increased with 3.0 mmHg after a PPV with indication retinal detachment (p < 0.001), but remained stable after PPV for epiretinal membrane (p = 0.555), macular hole (p = 0.695), and vitreous hemorrhage (p = 0.787). At the end of the follow-up period the number of IOP-lowering medications was significantly higher compared to baseline, except in the macular hole group (p = 0.103). Also, the number of eyes that underwent glaucoma surgery was significantly higher compared to the fellow (not-operated) eyes (p < 0.001). There was a significant association between the number of PPV’s and the final IOP for the indication retinal detachment (p = 0.009), and between the number of PPV’s and glaucoma surgery (odds ratio [95% confidence interval]: 2.60 [1.62–4.15]).ConclusionsThe IOP rises significantly after PPV with indication retinal detachment. This association was not found for other indications for PPV. Also, the risk of IOP-lowering surgeries was higher after PPV, but not different between the PPV indications. The IOP should be monitored carefully after PPV, since there may be a higher risk of secondary glaucoma.
Highlights
To assess the relationship between different indications for trans pars plana vitrectomies (PPV’s) and the intraocular pressure (IOP), and the effect of multiple pars plana vitrectomy (PPV)’s on the IOP
None of the patients had a history of glaucoma surgery before they underwent PPV
PPV pars plana vitrectomy, SF6 sulfurhexafluoride, C3F8 perfluoropropane glaucoma surgery increased 2.60 fold, especially for the indication retinal detachment (OR: 4.60 [95% Confidence interval (CI): 1.54–13.75])
Summary
To assess the relationship between different indications for trans pars plana vitrectomies (PPV’s) and the intraocular pressure (IOP), and the effect of multiple PPV’s on the IOP. We examined whether there were differences in the number of IOP-lowering medications or surgeries before and after PPV. The introduction of pars plana vitrectomy (PPV) has led to a great advancement in treating conditions of the posterior segment of the eye. Many studies have described the influence of PPV on IOP, the influence of the indication and the number of PPV’s on the long-term IOP has not yet been clarified even though repeated PPV’s are not uncommon. The aim of the present study was first to assess the relationship between the most common indications for a PPV and the IOP. We assessed whether the number of PPV’s was associated with a higher IOP or a higher risk of undergoing glaucoma surgery
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