Purpose: To discuss the incidence and clinical features of early and mid-late elevated intraocular pressure after pars plana vitrectomy and silicone oil injection, and to evaluate the clinical management of eyes with secondary glaucoma.
Methods: This was an observational consecutive case series of 691 eyes in 679 patients who were treated with pars plana vitrectomy and silicone injection. The diagnostic criteria of early elevated intraocular pressure after silicone oil injection was ≥ 21 mmHg two weeks after surgery, while mid-late elevated intraocular pressure was ≥ 21 mmHg after two weeks. The incidence and clinical management of elevated intraocular pressure were analyzed.
Results: In total, 211 of 691 eyes (30.54%) developed elevated intraocular pressure two weeks after pars plana vitrecto my and silicone injection. Of the 211 eyes, 101 eyes (47.87%) had ocular inflammation, 64 eyes (30.33%) showed hyphema, 35 eyes (16.59%) had silicone oil in the anterior chamber, 6 eyes (2.84% ) had excess silicone oil injected, and 5 eyes (2.37%) had rubeosis irides. Eighty three of 691 eyes (12.01%) developed elevated intraocular pressure after two weeks. Of these 83 eyes, 25 eyes (30.12%) had rubeosis irides, 16 eyes (19.27%) had issues related to topic steroid therapy, 13 eyes (15.66%) had a papillary block, silicone oil in the anterior chamber, 10 eyes (12.05%) had a silicone emulsion, 10 eyes (12.05%) had peripheral anterior synchiae, and 9 eyes (10.84%) had silicone oil in the anterior chamber. All eyes with elevated intraocular pressure were treated with antiglaucoma medications and surgeries.
Conclusion: The reasons for elevated intraocular pressure differed between early and mid-late after pars plana vitrectomy and silicone oil injection. The elevated intraocular pressure can be controlled effectively by immediate diagnosis and proper treatment with medicine and operation.