Intraocular pressure 1 year after vitrectomy in eyes without a history of glaucoma or ocular hypertension

Fang, Yuan; Long, Qingqing; Wang, Xiaoqian; Jiang, Rui; Sun, Xinghuai

doi:10.2147/opth.s144985

Cited by 25 publications

(33 citation statements)

References 30 publications

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“…Regarding the characteristics of a longer globe, thinner lamina cribrosa, compromised autoregulatory control of ocular hemodynamics and thinner scleral wall with different elasticity, even a transient IOP increase or fluctuation during the vitrectomy may be sufficient to cause damage. Furthermore, there is increasing evidence that high myopia and vitrectomy themselves may be a risk factor for development or worsening of glaucoma (Fang et al 2017). Thus, shortening the operation time, reducing the IOP fluctuation during the vitrectomy and careful perioperative IOP monitoring are required to manage these patients.…”

Section: Discussionmentioning

confidence: 99%

Treatment of macular hole retinal detachment with macular plug in highly myopic eyes: three‐year results

Ling

Chuang

et al. 2020

Acta Ophthalmologica

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To investigate the long-term surgical outcomes of macular hole retinal detachment (MHRD) following vitrectomy with macular plug in highly myopic eyes. Methods: Thirty-five cases of highly myopic eyes with MHRD in 35 patients who underwent an initially successful vitrectomy with macular plug and were followed up for at least 3 years were reviewed. The anatomical outcomes were evaluated by fundus examination, fundus photographs and optical coherence tomography (OCT). Myopic features after the surgery were differentiated according to recommendations of the Meta-analysis of Pathologic Myopia (META-PM) Study Group. The best-corrected visual acuities (BCVAs) before and after surgery were analysed as the functional outcome. Main outcome measures time-course changes in BCVA and complications. Results: The mean patient age was 61.0 AE 11.4 years. The follow-up was 45.2 AE 8.6 months (ranged from 36 to 71 months). The mean axial length was 29.3 AE 1.2 mm. All eyes demonstrated attached retina, but 2 eyes (5.7%) developed reopened macular holes until the last follow-up. Complications of postoperative rhegmatogenous retinal detachment were detected in 2 eyes (5.7%) within 1 year and retina reattached after the secondary vitrectomy. Three cases (8.6%) of prolonged subretinal fluid lasting more than 1 year were detected but finally absorbed completely. Comparing 1-3 years postoperatively, myopic features showed significant progression of myopic maculopathy category (p = 0.035). Functionally, significantly improved BCVA could be maintained postoperatively between 6 months and 3 years. However, vision of 14 eyes (40.0%) worsened within 1-3 years postoperatively, and visual deterioration was associated with progression of myopic maculopathy (p = 0.004) and preexisting disease of glaucoma (p = 0.006). Conclusions: A vitrectomy combined with macular plug provided favourable outcomes in the long term, over the ≥3-year follow-up period.

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Section: Discussionmentioning

confidence: 99%

Treatment of macular hole retinal detachment with macular plug in highly myopic eyes: three‐year results

Ling

Chuang

et al. 2020

Acta Ophthalmologica

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“… 21 – 24 In our previous study, we reported that about 20% of the patients who underwent PPV at our hospital in November 2011 had no history of glaucoma or ocular hypertension, but suffered ocular hypertension during the first postoperative year. 6 Most ocular hypertension occurs in the first month after PPV. 6 Risk factors for ocular hypertension after PPV include a history of glaucoma, a history of diabetes mellitus, scleral buckling procedures, lensectomy, and the use of silicone oil or expanding gas.…”

Section: Discussionmentioning

confidence: 99%

“… 6 Most ocular hypertension occurs in the first month after PPV. 6 Risk factors for ocular hypertension after PPV include a history of glaucoma, a history of diabetes mellitus, scleral buckling procedures, lensectomy, and the use of silicone oil or expanding gas. 6 …”

Section: Discussionmentioning

confidence: 99%

“…Ocular hypertension is a common complication of PPV. 5 Our previous study showed that about 20% of the patients with no history of glaucoma or ocular hypertension suffered ocular hypertension during the 1-year follow-up period after PPV, 6 most in the first month after PPV. 6 To reduce the incidence of early-onset ocular hypertension and the damage it causes to the optic nerve and retina, some surgeons prophylactically administer IOP-lowering drugs on postoperative day 1 after PPV in patients with a high risk of ocular hypertension.…”

Section: Introductionmentioning

confidence: 99%

“… 5 Our previous study showed that about 20% of the patients with no history of glaucoma or ocular hypertension suffered ocular hypertension during the 1-year follow-up period after PPV, 6 most in the first month after PPV. 6 To reduce the incidence of early-onset ocular hypertension and the damage it causes to the optic nerve and retina, some surgeons prophylactically administer IOP-lowering drugs on postoperative day 1 after PPV in patients with a high risk of ocular hypertension. 7 – 9 In this study, we collected data on patients who had undergone PPV at our hospital in November 2007, November 2011, or November 2015 to investigate the trends in the demographics of these patients, the procedures used for PPV, and the prophylactic use of IOP-lowering medicines from 2007 to 2015.…”

Section: Introductionmentioning

confidence: 99%

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Trends in the characteristics of vitrectomy in Eastern China

Fang

Liu

et al. 2018

OPTH

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BackgroundSeveral new instruments and techniques for pars plana vitrectomy (PPV) have been widely used in recent years, but information about the related characteristics of PPV in China is limited. To investigate the trends in the characteristics of PPV in Eastern China, an 8-year retrospective study was conducted.Patients and methodsWe collected data from patients who underwent PPV at the Eye, Ear, Nose and Throat Hospital of Fudan University, Shanghai, China, in November 2007, November 2011, and November 2015. Cases of trauma-related retinopathy were excluded. Data on the patient demographics, surgical procedures, and the prophylactic use of IOP-lowering medications were collected and analyzed.ResultsIn 2015, most PPVs were conducted with a 23-gauge system, whereas all PPVs in 2007 and 2011 were conducted with a 20-gauge system. The proportions of macular disease in the population in 2007, 2011, and 2015 were 9.1%, 10.7%, and 21.5%, respectively (P<0.001). The proportion of PPV that was combined with lens extraction and intraocular lens (IOL) implantation increased significantly from 12.81% in 2007 to 25.95% by 2015 (P<0.001). The proportions of patients treated with IOP-lowering drugs in 2007, 2011, and 2015 were 27.40%, 38.20%, and 12.60%, respectively (P<0.001). In 2007, systemic carbonic anhydrase inhibitors (CAI-Ss) and beta blockers (BBs) were the two main types of prophylactic IOP-lowering drugs administered, but their use had decreased in 2015 (P<0.001). The preventive use of adrenergic agonists (AAs), topical carbonic anhydrase inhibitors (CAI-Ts), and prostaglandin analogs (PGAs) became increasingly frequent from 2007 to 2015 (P<0.05).ConclusionThe 23-gauge system, rather than the 20-gauge system, had become the mainstream PPV instrument by 2015. The proportion of macular disease patients requiring PPV in China clearly increased, and the rate of prophylactic IOP-lowering drug use decreased by 2015.

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Incidence of Management Changes at the Postoperative Day One Visit After Pars Plana Vitrectomy for Retinal Detachment

Patel

Borkar

Madhava

et al. 2021

American Journal of Ophthalmology

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Purpose To evaluate the incidence of unexpected management changes on the first day after pars plana vitrectomy for retinal detachment repair Design Retrospective cohort study Participants All cases of pars plana vitrectomy (PPV) for rhegmatogenous or tractional retinal detachment with completed postoperative day one (POD1) and week one (POW1) visits were included. Methods The medical and billing records of a large academic private practice were electronically queried for all cases of PPV for retinal detachment performed between January 1, 2017 and December 31, 2017. The preoperative consultation, operative report, and POD1 and POW1 (postoperative days 5-14) visits were reviewed. Main Outcome Measures Incidence of unexpected management changes (change in or extended positioning, additional procedure, change in drop regimen, or shortened interval follow-up) at the POD1 visit after uncomplicated PPV for retinal detachment. Results Overall, 418 surgeries from 364 eyes and 355 patients were included. Eleven cases (2.6%) had an intraocular pressure (IOP) over 30 mmHg at POD1. IOP lowering drops were prescribed for 30 cases (7.2%). Silicone oil tamponade was positively associated with high IOP at POD1 (RR = 3.23, 95% CI 0.96 –10.84, P = 0.06). No additional management changes were made besides treating elevated IOP. Conclusions Management changes POD1 after vitrectomy for retinal detachment repair are relatively uncommon and were solely IOP related in this patient group. There may be flexibility regarding the type of POD1 encounter necessary, including an IOP check with an ophthalmic technician or non-retinal eye care provider. Larger, prospective studies are needed to better determine the most efficient follow-up routine.

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Intraocular pressure 1 year after vitrectomy in eyes without a history of glaucoma or ocular hypertension

Cited by 25 publications

References 30 publications

Treatment of macular hole retinal detachment with macular plug in highly myopic eyes: three‐year results

Treatment of macular hole retinal detachment with macular plug in highly myopic eyes: three‐year results

Trends in the characteristics of vitrectomy in Eastern China

Incidence of Management Changes at the Postoperative Day One Visit After Pars Plana Vitrectomy for Retinal Detachment

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