Risk Factors for Elevated Intraocular Pressure on First Day Postoperative Review following Pars Plana Vitrectomy

Purpose: To assess the relationship between day one post-operative intra-ocular pressure and patient demographic information, lens status, tamponade medium (air, perfluoroethane, sulfur hexafluoride) and laser treatment.

Methods: A prospective observational study of all patients undergoing pars plana vitrectomy by a single surgeon within one case study. All patients had intraocular pressure recorded one-day after surgery. None of the patients had postoperative anti-glaucoma medications. All patients undergoing pars plana vitrectomy were previously pseudophakic or underwent combined surgery.

Results: Out of a final cohort of 161 patients, 6% had raised IOP (defined as >30mmHg). A parsimonious regression model showed no strong correlation between raised IOP and type of gas tamponade (p=0.028 for C2F6, p=0.067 for SF6, air was the reference category), and a moderate association with number of laser burns (p=0.067).

Conclusion: The use of gas tamponade, in particular C2F6, does not constitute justification for pre/post-operative anti –glaucoma prophylactic treatment. In addition we postulate that careful consideration should be given to the frequency of laser burns during PPV.