Preoperative risk factors for uncontrolled intraocular pressure after vitrectomy combined with intrascleral fixation of the intraocular lens.

PURPOSE: To evaluate the factors affecting uncontrolled intraocular pressure (IOP) in eyes with crystalline lens, intraocular lens (IOL) dislocation, or aphakia after pars plana vitrectomy (PPV) combined with the flanged intrascleral IOL fixation technique (ISF) (PPV-ISF), and to examine the risk of high IOP or glaucoma surgery after PPV-ISF.

STUDY

DESIGN

Retrospective observational cohort study

METHODS

This study investigated 100 eyes (97 patients) who underwent PPV-ISF at Osaka University Graduate School of Medicine between July 2020 and June 2022. We evaluated the association of the outcomes of postoperative IOP control with preoperative and postoperative factors. Uncontrolled IOP was defined as an increase in glaucoma eye-drop use or necessity of glaucoma surgery.

RESULTS

The mean patient age was 67.9 ± 16.1 years. Among 100 eyes, 13 (13%) were diagnosed with exfoliation syndrome (XFS). Age and XFS were associated with preoperative ocular hypertension (P = .03, P = .005). After PPV-ISF, the use of eye drops was increased in 25 patients, and 10 eyes (10%) underwent glaucoma surgery. In the multiple logistic regression analysis, the odds ratios for uncontrolled IOP in XFS, previous glaucoma surgery, and previous vitrectomy surgery were 5.67 (P = .001), 8.98 (P = .004), and 1.43 (P = .508), respectively.

CONCLUSION

XFS and history of glaucoma surgery are associated with poor IOP control after PPV-ISF surgery.