Immediate postoperative use of a topical agent to prevent intraocular pressure elevation after pars plana vitrectomy with gas tamponade.
OBJECTIVE
To determine whether a single topical aqueous suppressant applied immediately after pars plana vitrectomy with long-acting gas tamponade prevents intraocular pressure (IOP) elevation.


METHODS
Fifty patients who met the inclusion criteria and underwent pars plana vitrectomy with long-acting gas tamponade were randomized to receive a combination of timolol maleate and dorzolamide hydrochloride, long-acting timolol alone, dorzolamide alone, or placebo at the conclusion of surgery. The IOP was checked by a portable, handheld tonometer (Tono-Pen) at the conclusion of surgery and at 5 hours, 1 day, and 1 week after surgery.


RESULTS
There were no significant differences in IOP among the groups at the conclusion of surgery. The IOP at 5 hours after surgery (27.0 vs 17.4 mm Hg; P<.001) and 1 day after surgery (26.1 vs 19.9 mm Hg; P =.01) showed a statistically significant difference between the placebo and timolol-dorzolamide groups. The timolol-dorzolamide group showed greater IOP control than either the timolol alone or the dorzolamide alone groups at 5 hours (P =.04 for both).


CONCLUSIONS
The use of a single topical aqueous suppressant (timolol-dorzolamide) given after pars plana vitrectomy with long-acting gas tamponade effectively prevents significant postoperative IOP elevation at 5 hours and 1 day after surgery.
Benz
Matthew S
MS
Bascom Palmer Eye Institute, University of Miami School of Medicine, Miami, FL, USA.
Escalona-Benz
Erika M
EM
Murray
Timothy G
TG
Eifrig
Charles W G
CW
Yoder
Daniel M
DM
Moore
Jeffrey K
JK
Schiffman
Joyce C
JC
D000287:Administration, Topical; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000959:Antihypertensive Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D005260:Female; D005466:Fluorocarbons; D006801:Humans; D007429:Intraocular Pressure / Q000187:drug effects*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000517:prevention & control*; D011184:Postoperative Period; D011446:Prospective Studies; D012163:Retinal Detachment / Q000601:surgery; D012167:Retinal Perforations / Q000601:surgery; D013449:Sulfonamides / Q000008:administration & dosage / Q000627:therapeutic use; D013459:Sulfur Hexafluoride; D013876:Thiophenes / Q000008:administration & dosage / Q000627:therapeutic use; D013999:Timolol / Q000008:administration & dosage / Q000627:therapeutic use; D014821:Vitrectomy
D000959:Antihypertensive Agents; D005466:Fluorocarbons; D013449:Sulfonamides; D013876:Thiophenes; D013999:Timolol; C062765:dorzolamide; C042852:perflutren; D013459:Sulfur Hexafluoride