J Korean Ophthalmol Soc.  2016 Jan;57(1):80-85. 10.3341/jkos.2016.57.1.80.

Long Term Incidence Rate of Glaucoma after Pars Plana Vitrectomy

• Choi HJ
• Lee DH
• Kim JH
• Shin JY
• Lee JH

• KMID: 2213845
• DOI: http://doi.org/10.3341/jkos.2016.57.1.80

Abstract

PURPOSE
To evaluate the incidence rate of postoperative glaucoma after pars plana vitrectomy (PPV) and to compare incidence rate of glaucoma between phakic and pseudophakic eyes.
METHODS
Retrospective chart review of patients who underwent PPV between January 2007 and May 2014. The outcome measure was the presence or absence of postoperative glaucoma, defined as definitive loss of neuro-retinal rim defect on fundus exam or showing glaucomatous change on a visual field test that warranted maintenance of ocular hypotensive therapy.
RESULTS
There were 333 patients average age 57.09 +/- 13.43 included this study. Patients were followed for an average of 56.23 +/- 10.85 months. There was no significant difference in mean intra ocular pressure (IOP) between the vitretomized eyes with unoperative eyes, except in mean IOP at one day postoperatively (p = 0.012). In unoperative eyes, 10 of 315 (3.1%) were newly diagnosed as postoperative glaucoma. For the vitrectomized eyes, 69 of the 351 (19.6%) were newly diagnosed as postoperative glaucoma. There was a significant difference in incidence rate of glaucoma between the two groups (p < 0.001, chi-square test). There was a significantly higher IOP in glaucoma eyes compared with normal eyes (p < 0.001, Repeated Measures Analysis of variance [RM-ANOVA]). A possible risk factor for the development of glaucoma after PPV was cataract surgery (p = 0.0497, chi-square test).
CONCLUSIONS
The incidence of glaucoma in patients with PPV is higher than in normal eyes. The incidence seems to increase particularly in those who have a pesudophakic eye. Patients who underwent PPV, especially in the pseudophakic state, need to have their IOP monitored carefully and managed properly by an ophthalmologist.

Keyword

Glaucoma; Intraocular pressure; Pars plana vitrectomy; Phacoemulsification

MeSH Terms

Cataract
Glaucoma*
Humans
Incidence*
Intraocular Pressure
Outcome Assessment (Health Care)
Phacoemulsification
Retrospective Studies
Risk Factors
Visual Field Tests
Vitrectomy*

Figure

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  Figure 1. Mean IOP of the vitrectomized eyes compared with the unoperative fellow eyes at baseline and postoperatively. IOP = intra ocular pressure. * There is no significant differ-ence in mean IOP between the two groups, except in mean IOP at postoperative 1 day ( p = 0.012).

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  Figure 2. Distribution of newly diagnosed glaucoma after PPV. PPV = pars plana vitrectomy; NVG = neovascular glau-coma; POAG = primary open-angle glaucoma.

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  Figure 3. Postoperative mean IOP changes in normal and glau-coma group (RM-ANOVA by Greenhouse-Geisser method: between p < 0.001, within p = 0.167). Statistically significant higher IOP in glaucoma group than in normal group. IOP = in-tra ocular pressure; RM-ANOVA = repeated measures analysis of variance; op = operative.

Reference

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