When a patient undergoes pars plana victrectomy (PPV), it is often to address a condition such as macular hole, macular pucker or vitreous hemorrhaging. In fact, it can address a slew of issues as benign as floaters and as severe as a retinal detachment.1 But when the original procedure doesn’t do the trick, patients are sometimes asked to return for a repeat surgery. In most cases, an additional procedure doesn’t have a significant impact on intraocular pressure (IOP). But a new study is suggesting that repeat PPV can significantly raise IOP in patients who initially presented with retinal detachments.2
Dutch researchers performed a retrospective study of 447 eyes that underwent PPV. They found the IOP increased by 3mm Hg after a PPV in patients who had an indication of retinal detachment, but remained stable after PPV for other indications, including epiretinal membrane, macular hole and vitreous hemorrhage. At the end of the follow-up period, the number of IOP-lowering medications was significantly higher in all groups except those with macular holes. Also, the number of eyes that underwent glaucoma surgery was significantly higher compared with fellow eyes.
The researchers noted a significant association between the number of PPVs and the final IOP for those with retinal detachment and between the number of PPVs and glaucoma surgery.
Pars plana vitrectomy is commonly recommended to patients with:
Spirn M. Pars plana vitrectomy. Eyewiki – American Academy of Ophthalmology. eyewiki.aao.org/Pars_Plana_Vitrectomy. April 22, 2019. Accessed August 20, 2019.
Kovacic H, Wolfs R, Kılıç E, Ramdas W. The effect of multiple vitrectomies and its indications on intraocular pressure. BMC Ophthalmol. 2019;19(1):175.