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INCIDENCE AND RISK FACTORS FOR HYPOTONY AFTER 25-GAUGE PARS PLANA VITRECTOMY WITH NONEXPANSILE ENDOTAMPONADE

Mimouni, Michael, MD*,†; Abualhasan, Hamza, MD*; Derman, Laura, MD*; Feldman, Assaf, BScMed; Mazzawi, Fares, BScMed; Barak, Yoreh, MD*,†

doi: 10.1097/IAE.0000000000002336
Original Study: PDF Only

Purpose: The purpose of this study was to assess the incidence and risk factors for early postoperative hypotony after 25-gauge pars plana vitrectomy with nonexpansile endotamponade.

Methods: A retrospective study of consecutive patients who underwent 25-G pars plana vitrectomy. Hypotony was defined as an intraocular pressure of 5 mmHg or less after surgery and ocular hypertension as an intraocular pressure greater than 21 mmHg.

Results: Overall, 307 eyes of 307 patients with a mean age of 61.7 ± 14.3 of which 56.7% were males were included. Hypotony was identified in 5.2% of cases (n = 16) at Day 1 and 0.7% (n = 2) at Week 1 with no hypotony-related complications. The hypotony group had a higher number of previous vitreoretinal surgeries (1.5 ± 1.1 vs. 0.4 ± 0.7, P < 0.001) and a higher prevalence of preoperative ocular hypertension (22.2% vs. 4.8%, P = 0.02), pseudophakia (77.8% vs. 48.4%, P = 0.01), silicone oil removal (61.1% vs. 8.3%, P < 0.001), and external diathermy performed (55.6% vs. 20.1%, P = 0.001). In stepwise multivariate analysis, significant parameters were silicone oil removal (R2 = 16.34%, odds ratio 13.45, P < 0.001), pseudophakia (R2 = 5.69%, odds ratio 3.65, P = 0.03), and younger age (R2 = 2.68%, odds ratio 0.96, P = 0.04).

Conclusion: Silicone oil removal is a significant risk factor for early postoperative hypotony after 25-G pars plana vitrectomy.

In this retrospective cohort study of 307 patients, the incidence and risk factors for early postoperative hypotony after 25-gauge pars plana vitrectomy with nonexpansile endotamponade was assessed. Silicone oil removal was identified as a significant risk factor for early postoperative hypotony after 25-G pars plana vitrectomy.

*Department of Ophthalmology, Rambam Health Care Campus, Haifa, Israel; and

Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel.

Reprint requests: Yoreh Barak, MD, Department of Ophthalmology, Rambam Health Care Campus, P.O.B 9602, Haifa, Israel 31096; e-mail: yoreh_b@rambam.health.gov.il

None of the authors has any financial/conflicting interests to disclose.

© 2018 by Ophthalmic Communications Society, Inc.