LATE-ONSET OCULAR HYPERTENSION AFTER VITRECTOMY: A Multicenter Study of 6, 048 Eyes. Issue 11 (November 2019)

• Record Type: Journal Article
• Authors: Reibaldi, Michele; Avitabile, Teresio; Russo, Andrea; Bonfiglio, Vincenza; Mariotti, Cesare; Romano, Mario R.; Boscia, Francesco; Cennamo, Gilda; Fallico, Matteo; Parisi, Guglielmo; Castellino, Niccolò; Bucolo, Claudio; Li Volti, Giovanni; Longo, Antonio
• Is Part Of: Retina. Volume 39:Issue 11(2019)
• Publication Date: 2019-11
• Subjects: late-onset ocular hypertension -- vitrectomy; Retina -- Diseases -- Periodicals; Retinal Diseases; Vitreous Body; 617.735
• DOI: 10.1097/IAE.0000000000002309
• Languages: English
• ISSNs: 0275-004X

Abstract

Abstract : Purpose: To determine the incidence and risk factors for late-onset ocular hypertension (LOH) after vitrectomy. Methods: From the electronic medical records of consecutive patients who underwent primary vitrectomy, from January 2010 to December 2015, at 5 tertiary vitreoretinal centers in Italy, patient demographics, systemic, ophthalmic, operative, and postoperative data were drawn. Main outcome measure was the presence of LOH, defined as intraocular pressure >21 mmHg detected more than 2 months after vitrectomy on at least 2 consecutive visits. Results: Among 6, 048 patients, LOH was found in 294 (4.9%) vitrectomized eyes and in 87 (1.4%) fellow eyes, (chi square; P < 0.001). Multivariable logistic regression showed that significant risk factors for developing LOH included intraoperative triamcinolone use (odds ratio [OR], 7.62; P < 0.001), longer axial length (OR, 1.55; P = 3.023), preoperative higher intraocular pressure (OR, 1.81; P = 0.003), and postvitrectomy pseudophakic/aphakic status (OR, 2.04; P < 0.001). Decision-tree analysis showed that the stronger predictor of LOH was intraoperative triamcinolone use ( P < 0.001). Secondary predictors were a preoperative intraocular pressure more than 15 mmHg ( P < 0.001) in eyes that use triamcinolone, and postvitrectomy pseudophakic/aphakic status ( P = 0.007) in eyes that did not use triamcinolone. Conclusion: Late-onset ocular hypertension occurred in 4.9% of vitrectomized eyes. The main risk factors were intraoperative use of triamcinolone and postvitrectomy pseudophakic/aphakic status. Abstract : Late-onset ocular hypertension occurs in 4.9% of eyes after vitrectomy, and intraoperative use of triamcinolone, a high intraocular pressure before the vitrectomy, and postvitrectomy pseudophakic status are the main variables associated with its incidence.