Canadian journal of ophthalmology. Journal canadien d'ophtalmologie · 2026
Intraocular pressure changes following vitrectomy with and without phacoemulsification: an American Academy of Ophthalmology IRIS® registry analysis.
СтатьяМногоцентровое исследованиеПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод в очереди
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Hoyek Sandra, Gilbert Joshua B, Chaaya Celine, Kearney William, Ross Connor, Lin Michael M, Vu Daniel M, Rothman Adam L, Elze Tobias, Lorch Alice, Miller Joan W, Patel Nimesh A, IRIS® Registry Analytic Center Consortium
Аннотация
OBJECTIVE: To describe observed intraocular pressure (IOP) changes following vitrectomy (PPV) surgery and PPV combined with phacoemulsification in eyes with and without glaucoma.
METHODS: A total of 20,894 patients from the American Academy of Ophthalmology IRIS® Registry (Intelligent Research in Sight) who underwent vitrectomy surgery for epiretinal membrane or vitreous opacities from January 2016 to March 2023 were included. Mean IOPs from postoperative day 1, days 2-10, days 11-30, and then monthly through 6 months were compared to baseline. The IOP spike was defined as having an IOP >30 mm Hg and an increase >10 mm Hg from baseline.
RESULTS: While IOP spikes were uncommon (<1%), a higher proportion of subjects demonstrated an IOP spike (0.8% vs 0.1%; p < 0.001) in the group with pre-existing glaucoma compared to the group without glaucoma, respectively. At 3 months post-surgery, the probability of an IOP spike was higher in this group (OR = 5.38, 95% CI [3.25 - 9.16]; p < 0.001). Eyes that underwent PPV only showed an increase in postoperative IOP, whereas those that underwent PPV combined with phacoemulsification showed a decrease in postoperative IOP. Longitudinal analysis of IOP showed an initial sharp decline in IOP on day 1, followed by an increase in IOP from week 1 through month 1 and a gradual decrease to postoperative month 3. Overall, eyes that underwent PPV combined with phacoemulsification showed a decrease in postoperative IOP relative to those with PPV alone.
CONCLUSIONS: For the entire post-vitrectomy cohort, there was an initial decrease in IOP at postoperative day 1, followed by a transient rise near postoperative month 1, and subsequently a decline to near-baseline level by month 3. Overall, IOP spikes were more frequent and more severe (>40) in the glaucoma/suspect group compared to the group without glaucoma. Ninety-day IOP decreases slightly following vitrectomy surgery in eyes without pre-existing glaucoma, while it increases in eyes with glaucoma, with differences not clinically significant.
METHODS: A total of 20,894 patients from the American Academy of Ophthalmology IRIS® Registry (Intelligent Research in Sight) who underwent vitrectomy surgery for epiretinal membrane or vitreous opacities from January 2016 to March 2023 were included. Mean IOPs from postoperative day 1, days 2-10, days 11-30, and then monthly through 6 months were compared to baseline. The IOP spike was defined as having an IOP >30 mm Hg and an increase >10 mm Hg from baseline.
RESULTS: While IOP spikes were uncommon (<1%), a higher proportion of subjects demonstrated an IOP spike (0.8% vs 0.1%; p < 0.001) in the group with pre-existing glaucoma compared to the group without glaucoma, respectively. At 3 months post-surgery, the probability of an IOP spike was higher in this group (OR = 5.38, 95% CI [3.25 - 9.16]; p < 0.001). Eyes that underwent PPV only showed an increase in postoperative IOP, whereas those that underwent PPV combined with phacoemulsification showed a decrease in postoperative IOP. Longitudinal analysis of IOP showed an initial sharp decline in IOP on day 1, followed by an increase in IOP from week 1 through month 1 and a gradual decrease to postoperative month 3. Overall, eyes that underwent PPV combined with phacoemulsification showed a decrease in postoperative IOP relative to those with PPV alone.
CONCLUSIONS: For the entire post-vitrectomy cohort, there was an initial decrease in IOP at postoperative day 1, followed by a transient rise near postoperative month 1, and subsequently a decline to near-baseline level by month 3. Overall, IOP spikes were more frequent and more severe (>40) in the glaucoma/suspect group compared to the group without glaucoma. Ninety-day IOP decreases slightly following vitrectomy surgery in eyes without pre-existing glaucoma, while it increases in eyes with glaucoma, with differences not clinically significant.