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LATE-ONSET OCULAR HYPERTENSION AFTER VITRECTOMY: A Multicenter Study of 6,048 Eyes

Reibaldi, Michele, MD, PhD*; Avitabile, Teresio, MD, PhD*; Russo, Andrea, MD, PhD*; Bonfiglio, Vincenza, MD*; Mariotti, Cesare, MD; Romano, Mario R., MD, PhD; Boscia, Francesco, MD§; Cennamo, Gilda, MD, PhD; Fallico, Matteo, MD*; Parisi, Guglielmo, MD*; Castellino, Niccolò, MD*; Bucolo, Claudio, MD, PhD; Li Volti, Giovanni, PhD; Longo, Antonio, MD, PhD*

doi: 10.1097/IAE.0000000000002309
Original Study: PDF Only

Purpose: To determine the incidence and risk factors for late-onset ocular hypertension (LOH) after vitrectomy.

Methods: From the electronic medical records of consecutive patients who underwent primary vitrectomy, from January 2010 to December 2015, at 5 tertiary vitreoretinal centers in Italy, patient demographics, systemic, ophthalmic, operative, and postoperative data were drawn. Main outcome measure was the presence of LOH, defined as intraocular pressure >21 mmHg detected more than 2 months after vitrectomy on at least 2 consecutive visits.

Results: Among 6,048 patients, LOH was found in 294 (4.9%) vitrectomized eyes and in 87 (1.4%) fellow eyes, (chi square; P < 0.001). Multivariable logistic regression showed that significant risk factors for developing LOH included intraoperative triamcinolone use (odds ratio [OR], 7.62; P < 0.001), longer axial length (OR, 1.55; P = 3.023), preoperative higher intraocular pressure (OR, 1.81; P = 0.003), and postvitrectomy pseudophakic/aphakic status (OR, 2.04; P < 0.001). Decision-tree analysis showed that the stronger predictor of LOH was intraoperative triamcinolone use (P < 0.001). Secondary predictors were a preoperative intraocular pressure more than 15 mmHg (P < 0.001) in eyes that use triamcinolone, and postvitrectomy pseudophakic/aphakic status (P = 0.007) in eyes that did not use triamcinolone.

Conclusion: Late-onset ocular hypertension occurred in 4.9% of vitrectomized eyes. The main risk factors were intraoperative use of triamcinolone and postvitrectomy pseudophakic/aphakic status.

Late-onset ocular hypertension occurs in 4.9% of eyes after vitrectomy, and intraoperative use of triamcinolone, a high intraocular pressure before the vitrectomy, and postvitrectomy pseudophakic status are the main variables associated with its incidence.

*Department of Ophthalmology, University of Catania, Catania, Italy;

Department of Ophthalmology, University of Ancona, Ancona, Italy;

Department of Ophthalmology, Second University of Napoli, Napoli, Italy;

§Department of Ophthalmology, University of Sassari, Sassari, Italy; and

Department of Biomedical and Biotechnological Sciences, University of Catania, Catania, Italy.

Reprint requests: Michele Reibaldi, MD, PhD, Department of Ophthalmology, University of Catania, Via Santa Sofia 78, Catania 95124, Italy; e-mail: mreibaldi@libero.it

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

© 2018 by Ophthalmic Communications Society, Inc.