Intraocular pressure elevation following pars plana vitrectomy and treatment

Elevation of intraocular pressure (lOP) is a frequent occurrence after pars plana vitrectomy. Severe pressure elevations may result in visual loss due to central retinal artery occlusion or optic nerve ischemia. IOL elevation can occure early or late period after surgery. There are several variables that are associated with an increased risk of early IOP elevation following pars plana vitrectomy; these include: Intraoperative scatter endophotocoagulation, and/or pars plana lensectomy performed at the same time as pars plana vitrectomy, gas expansion, silicone-oil, inflammatory, corticosteroid response and postvitrectomy hemorhage. At late period, it's notified that pupillary bloc depends on silicon oil, inflamation, synechial angle closure , rubeosis iridis and also glaucoma that is consisted of migrating of emulsified or non-emulsified silicon oil towards anterior chamber. In this study, we elaluated the frequency of IOP elevetion following PPV the mechanisns and its reletionship with applied surgical procedure. 107 patients' data who underwent transconjunctival PPV, between Jan '13-Jan '16 at Akdeniz University Faculty of Medicine ophtalmology depertmant is evaluated retrospectively. Glaucoma was diagnosed in cases where IOP was greater than 21 mm / hg on postoperative two IOP measurements, greater than 4 mm / Hg preoperatively, or greater than 4 mm / Hg greater than other eye IOP values. At the same time, it will be exact diagnosis when glaucomatous changes are seen at optic disc. OCT-RSLT is used as image method. Open-angle glaucoma is diagnosed when anterior chamber is deep at postoperative, iridocorneal angle is open and IOP doesn't depend on another reasons. If IOP depends on another reasons, it is called secondary glaucoma. In our study, IOP elevation following PPV frequency is found %43. The diferrence between glaucoma and lensectomy, intravitreal steroid and endolaser wasn't found to be statistically significant (p>0,05). In the late period, the most important cause of IOP increase is silicone emulsification. Silicone emulsification was found at 48%. In advanced postoperative period, the rate of open angle glaucoma in vitrectomized eyes is 21.5%. There was no statistically significant relationship between open angle glaucoma and postoperative lens status. (p>0,05). A large majority of patients with post-PPV IOP elevation were below 21 mm / Hg in IOP by medical treatment. IOP elevation after PPV is a common complication, so patients should be closely monitored for IOP values at each postoperative period. IOP should be reduced by interfering with the disease in which the IOP increase is detected. Key words: Pars plana vitrectomy, Glaucoma, secondary glaucoma, open angle glaucoma, endotamponad