Intraocular Pressure After Uncomplicated Small-Gauge Pars Plana Vitrectomy Repair of Primary Rhegmatogenous Retinal Detachments
Purpose
A consecutive interventional case series from one retina practice (n=186) of eyes with or without existing history of primary open-angle glaucoma (POAG) who underwent RD repair with 23 or 25-gauge instrumentation with or without the use of scleral buckle (SB) between 2010 and 2012 was completed.
Methods
Gas type and concentration (C3F8 (perfluoropropane) and SF6 (sulfur hexafluoride)) used during PPV were documented. IOP was measured by Goldmann applanation during the pre-operative period, on post-operative day 1, week 1, month 1, month 3, and final follow-up day.
Results
Pre-operative POAG (n=14) was associated with higher IOP at week 1: 23.69 ± 2.02 vs. 16.81 ± 6.43 in eyes without POAG, and final IOP 16.86 ± 2.71 vs. 14.91 ± 3.21 in eyes without POAG (p<0.01, p<0.05). Mean IOP in eyes with C3F8 (n=76) on post-operative day 1 (19.18 ± 9.11) was greater than SF6 (16.39 ± 8.22) (n=104) (p=0.033). In glaucoma eyes, 15-16% C3F8 was associated with a higher final IOP than 20-25% SF6 gas (18.50 ± 2.12 vs. 17.33 ± 3.67) (p=0.047). Use of SB was associated with higher IOP at post-operative day 1 vs. non-SB use (20.88 ± 8.85 vs. 16.94 ± 8.54) (p=0.033).
Conclusion
IOP elevations are common after gas tamponade for RD repair. C3F8, SF6, and SB-use are associated with higher IOP. Patients with a history of POAG have higher post-operative IOPs and must be closely monitoring in the post-operative period.