Incidence of Late-onset Ocular Hypertension Following Uncomplicated Pars Plana Vitrectomy in Pseudophakic Eyes

• Published in: American journal of ophthalmology 2015-04, Vol.159 (4), p.727-732.e1
• Main Authors: Toyokawa, Noriko, Kimura, Hideya, Matsumura, Miyo, Kuroda, Shinichiro
• Format: Article
• Language: English
• Subjects: Adult; Age; Aged; Antihypertensive Agents - therapeutic use; Diabetic retinopathy; Eyes & eyesight; Female; Follow-Up Studies; Glaucoma; Hemorrhage; Humans; Hypertension; Incidence; Intraocular Pressure - physiology; Macular degeneration; Male; Medical records; Middle Aged; Ocular Hypertension - drug therapy; Ocular Hypertension - epidemiology; Ocular Hypertension - etiology; Ophthalmology; Postoperative Complications; Postoperative period; Pseudophakia - complications; Retinal Diseases - surgery; Retrospective Studies; Studies; Vitrectomy; Vitreous Hemorrhage - surgery
• ISSN: 0002-9394; 1879-1891
• DOI: 10.1016/j.ajo.2015.01.010

Purpose To determine the incidence of late-onset ocular hypertension following uncomplicated vitrectomy in pseudophakic eyes with an open angle. Design A retrospective observational case series. Methods Seven hundred and sixty-seven eyes of 767 patients that underwent vitrectomy combined with cataract surgery in 1 eye were studied. There were 383 men and 384 women. The indications for vitrectomy were: 308 eyes with rhegmatogenous retinal detachment, 202 eyes with epiretinal membrane, 169 eyes with macular hole, 44 eyes with vitreous hemorrhage, 16 eyes with subretinal hemorrhage, 15 eyes with vitreomacular traction syndrome, 12 eyes with vitreous opacity, and 1 eye with retinoschisis. Of these, 176 eyes underwent vitrectomy alone because of previous cataract surgery. Late-onset ocular hypertension was defined as an intraocular pressure (IOP) >21 mm Hg that developed more than 2 months postoperatively in at least 2 postoperative visits. An increase in the IOP >4 mm Hg over the preoperative IOP was necessary. Eyes with ocular hypertension, glaucoma (suspect), or a possibility of IOP elevation were excluded. Results The mean age was 63 ± 11 years. The mean follow-up duration after vitrectomy was 47.8 ± 25.3 months. Thirty-two eyes (4.2%) developed late-onset ocular hypertension. The mean age was 60 ± 10 years. The mean interval between vitrectomy and development of ocular hypertension was 31.1 ± 26.0 months. There were no significant differences in the incidence of late-onset ocular hypertension and the vitreoretinal disease for vitrectomy, sex, or gauge of instruments for vitrectomy. Conclusion Long-term IOP monitoring is necessary after vitrectomy.