long-term intraocular pressure alterations after ...

6th World Glaucoma Congress 2015 - Abstract Book

Poster Abstracts

Intraocular Pressure/physiology Pharmacology

P-T-140

LONG-TERM INTRAOCULAR PRESSURE ALTERATIONS AFTER DIABETIC VITRECTOMY Fehim Esen* 1, Osman Cekic1, Elvan Kucukkomurcu1, Muhsin Eraslan1 1 Department of Ophthalmology, Marmara University Medical Faculty, Istanbul, Turkey Background: To evaluatethe long-term intraocular pressure (IOP) changes following pars planavitrectomy (PPV) for eyes with proliferative diabetic retinopathy. Methods: Twenty-four eyes of 22 patients (8 female, 14 male; mean age: 54 years) that underwent PPV for the complications of proliferative diabetic retinopathy were retrospectively studied. Preoperative and regular follow-up anterior and posterior segment examinations and IOP measurements were recorded while use of glaucoma medications were tabulated. At baseline, only one patient had increased IOP and was using glaucoma medication. The last follow-up examinations and IOP measurements were obtained in eyes without any intravitreal tamponading agents. Results: Mean follow-up time was 10.3 months. Silicone oil (n = 14), C3F8 gas (n = 6) or balanced salt solution (n = 4) was infused at the conclusion of PPV. Silicone oil was removed at a mean of 3 months after vitrectomy. At the last follow-up, all operated eyes had flat retina. Mean (±standard deviation) baseline IOP was 15.0 ± 7.6 mmHg while last follow-up IOP was 17.1 ± 8.1 mmHg (p = 0.52, Wilcoxon signed-rank test). At the last examination, 3 out of 24eyes (12.5%) were on glaucoma medication to keep IOP under 22 mmHg. The long-term use of glaucoma medication did not change significantly after PPV (x2 = 1.09, p = 0.29, Chi-square test). None of the patients needed laser or surgical treatment for high IOP, nor any of them developed rubeosis iridis during the study period. Iridocorneal angles were open in all eyes and no posterior synechia existed at final examination. Conclusion(s): There is conflicting data on the long-term impact of vitrectomy on IOP. The initial studies reported elevated IOP after PPV for various disorders in the long-term whilst some others did not confirm this finding. A more recent work speculated that significant long-term IOP changes occurring after PPV may be associated with the underlying disease. The current study has shown that, in patients with proliferative diabetic retinopathy, absence of vitreous does not cause significant IOP elevationin the long-term.

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