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Intraocular Pressure Elevation after Vitrectomy for various Vitreoretinal Disorders

Purpose: To determine the incidence of and risk factors for intraocular pressure (IOP) elevation in the immediate postoperative period after vitrectomy for various vitreoretinal disorders. Methods: A prospective study was performed in 228 consecutive patients with various vitreoretinal disorders. The IOP was measured before surgery, at the end of surgery, and at 5 hours and 1 day after surgery using Tono-Pen XL®. The IOP at the end of surgery was adjusted to 15.0 ± 2.0 mm Hg. Results: Intraocular pressure elevation (>25 mm Hg) was found in 55 (24.1%) and 52 (22.8%) patients at 5 hours and 1 day postoperatively, respectively. The IOP at 5 hours was significantly lower in patients with macular hole (MH) than in those with diabetic macular edema, proliferative diabetic retinopathy (PDR), proliferative vitreoretinopathy, or rhegmatogenous retinal detachment (RD). The IOP at 1 day was significantly higher in patients with PDR and RD than in those with MH and epiretinal membrane. Multiple regression analysis revealed that IOP at 5 hours postoperatively had a significant correlation with the number of laser photocoagulation, preoperative IOP, combined cataract surgery, and 20-gauge vitrectomy. The IOP at 1 day postoperatively was significantly associated with these 4 parameters as well as the severity of postoperative vitreous hemorrhage and use of expanding gas tamponade. Conclusions: Intraocular pressure elevation was found in approximately one-quarter of cases within 1 day following vitrectomy. The risk factors for IOP elevation included number of laser photocoagulation, combined cataract surgery, severity of postoperative vitreous hemorrhage, and use of expanding gas tamponade.