Ophthalmic hypertension in patients after vitreoretinal surgery with various tamponades of the vitreal cavity

Abstract

Purpose. To analyze the cases of ophthalmic hypertension in patients after vitreoretinal surgery with various tamponades of the vitreal cavity. Material and methods. We analyzed 344 case histories of patients aged 30 to 80 who underwent vitreoretinal intervention with various tamponades of the vitreal cavity for macular rupture, epiretinal membrane, hemophthalmia, retinal detachment in 2019–2021. To detect ophthalmic hypertension, all patients underwent tonometry before surgery and every month after it during the entire 2-year follow-up period.Results. Of the 46 patients who were diagnosed with ophthalmic hypertension after vitreoretinal surgery, 18 patients achieved intraocular pressure compensation within the 2 year follow-up and they required no hypotensive therapy. 28 patients, including 4 patients who had glaucoma before vitreoretinal intervention were prescribed hypotensive therapy (carbonic anhydrase inhibitors, 2 adrenomimetics), 2 patients received an implantation of an Express anti-glaucomatous device.Conclusions. The analysis of ophthalmic hypertension in patients after vitreoretinal surgery showed that post-surgical IOP increase occurs both in cases of applying tamponade with silicon oil and those using sterile air or gasair mixture. Intraocular pressure compensation follows different patterns in every case, so that an individual approach is needed. Using one antihypertensive drug may be insufficient so in some cases a stronger antihypertensive therapy is required and sometimes anti-glaucomatous surgical interventions have to be resorted to.

Keywords

• vitreoretinal surgery
• ophthalmic hypertension
• secondary glaucoma