Risk factors of early postoperative high intraocular pressure after improved 23-gauge vitrectomy

Abstract:

AIM: To observe the incidence of high intraocular pressure(IOP)and its risk factors in the early stage(within 7d)after 23-gauge sutureless microincisional vitrectomy.

METHODS: Retrospective case series study. Totally 98 patients(98 eyes)who had undergone 23-gauge sutureless microincisional vitrectomy were enrolled. IOP was measured by non-contact tonometry. High IOP was defined as an IOP >25mmHg at any time within 7d after surgery. The influence of age, sex, side of operation, course of disease, primary disease pre-operation, reoperation, surgical options, type of tamponade, status of lens, surgical time on postoperative high IOP were analyzed.

RESULTS:High IOP was found in 33 eyes(33.7%)within 7d after surgery. High IOP was found in 8 eyes on postoperative 1d, the incidence was 24.2%(8/33), and 25 eyes was found on postoperative 3d, the incidence was 75.8%(25/33). The incidence of high IOP of male and female were 32.8%(20/61)and 35.1%(13/37)respectively. The incidence of high IOP of right and left eye were 36.8%(21/57)and 29.3%(12/41)respectively. There were no significant differences comparing age(Z=-0.22), sex(χ²=0.057), side of operation(χ²=0.612), course of disease(Z=-0.079)and surgical time(Z=-0.553)between patients with high IOP and those without it(P>0.05). Similarly, no statistical significance was found between eyes with gas tamponade and silicone oil tamponade(χ²=1.04), traumatic eyes and non traumatic eyes(χ²=0.044), and retinal detachment eyes and without retinal detachment eyes(χ²=2.282,P>0.05). The incidence of high IOP in eyes with several operations was higher than that in eyes with the first operation(χ²=5.211,P<0.05), in eyes with combined operations eyes was significantly higher than that in eyes with pure vitrectomy(χ²=4.57,P<0.05), and in eyes with aphakic eye was higher than that in eyes with phakic eyes(χ²=4.224,P<0.05).

CONCLUSION:High IOP occurs commonly in 3d after 23-gauge sutureless microincisional vitrectomy. The risk factors of high IOP are reoperation, combined operations and aphakic eye.