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The role of day one postoperative review of intraocular pressure in modern vitrectomy surgery
  1. Nicholas Brennan1,
  2. Ian Reekie2,
  3. Eric Ezra1,
  4. Keith Barton1,
  5. Ananth Viswanathan1,
  6. Mahiul MK Muqit1
  1. 1Moorfields Eye Hospital, London, UK
  2. 2Department of Ophthalmology, Hairmyres Hospital, East Kilbride, UK
  1. Correspondence to Mahiul MK Muqit, Vitreoretinal Service, Moorfields Eye Hospital, 162 City Rd, London EC1V 2PD, UK; mahi.muqit{at}moorfields.nhs.uk

Abstract

Background With the introduction of sutureless 23-gauge (23G) vitrectomy, the risks for elevated intraocular pressure (IOP) and the need for day 1 review of IOP are less certain.

Aims To assess current practice for postoperative review in the vitreoretinal service at a large tertiary referral centre; to assess whether day 1 review detected complications altering patient management; to identify risk factors for IOP spikes postvitrectomy.

Methods Retrospective, consecutive case note review of all patients undergoing 23G vitrectomy at the study institution between April and June 2013. Patients had assessment at either day 1, week 2 and month 2 or week 2 and month 2. Linear regression analysis was performed to identify risk factors for IOP elevation.

Results 200 (89%) cases met inclusion criteria. Of these, 176 (89.3%) had day 1 review, 24 (12%) were seen at week 2. Mean follow-up was 120 days (range 20–360). Two cases (1%) required urgent surgical intervention due to early IOP complications. Combined laser was the only risk factor for a day 1 IOP spike (p=0.005). In total, 44 patients (22%) were treated for elevated IOP within 2 weeks following vitrectomy. No long-term complications were detected in these patients.

Conclusions Day 1 review detected adverse events in 0.5% of study patients. No long-term complications were reported in the 22% of patients who received treatment for early postoperative IOP elevation. This observation has led to the removal of routine day 1 review from the surgical care pathway following routine uncomplicated vitrectomy at the study institution.

  • Intraocular pressure
  • Treatment Surgery

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Footnotes

  • Contributors All authors meet the criteria for authorship laid down by the ICMJE. NB made contributions to the conception and design of the work, the acquisition, analysis or interpretation of the data and has contributed to the drafting of the work and revising it for intellectual content and had approved the final version for publication. IR made contributions to the acquisition, analysis or interpretation of the data and has contributed to the drafting of the work and revising it for intellectual content and had approved the final version for publication. EE, KB and AV made contributions to the conception and design of the work, and have contributed to the drafting of the work and revising it for intellectual content and had approved the final version for publication. MMKM made contributions to the conception and design of the work, the acquisition, analysis or interpretation of the data and has contributed to the drafting of the work and revising it for intellectual content and had approved the final version for publication. All authors agree to be accountable for all aspects of the work.

  • Competing interests None declared.

  • Ethics approval Moorfields Eye Hospital Institutional Board.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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