News in Review
Vitrectomy Linked With Sustained IOP Elevation
Pars plana vitrectomy for epiretinal membrane (ERM) appears to increase the risk of sustained elevated intraocular pressure (IOP), particularly in the setting of pseudophakia or a family history of glaucoma, a retrospective study has concluded.1
Lead author Lihteh Wu, MD, and coauthors from the Pan American Collaborative Retina Study Group retrospectively examined IOP data from 198 patients who had a vitrectomy and membrane peeling for idiopathic macular ERM. Average follow-up was 47.3 ± 24 months (range, 12-106 months). Dr. Wu is a vitreoretinal surgeon at the Instituto de Cirugia Ocular in San José, Costa Rica.
Results. Sustained IOP elevation was defined as IOP of 24 mmHg or greater or an increase of 5 mmHg or more that persisted for two visits and warranted IOP-lowering therapy. It developed in 38 vitrectomized eyes (19.2 percent) compared with nine (4.5 percent) of the unoperated fellow eyes (p < .0001), the researchers found. The only statistically significant IOP risk factors in the vitrectomized eyes were cataract surgery (p < .0270) and a family history of open-angle glaucoma (p < .0004).
Clinical implications. “Comprehensive ophthalmologists should be aware that patients who have undergone a vitrectomy, even if it’s uncomplicated, may develop ocular hypertension over the long term. So they should keep checking the pressure regularly, particularly if the patient has undergone cataract surgery,” said Dr. Wu.
In addition, he advised cataract surgeons to watch for elevated IOP over several months in patients who had a previous vitrectomy. “This is a problem that develops slowly over time,” he said.
The group is now conducting a prospective study to confirm the findings.
1 Wu L et al. Retina. 2014;34(10):1985-1989.
Dr. Wu reports no related financial interests.
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