title: Intraocular pressure instability after 23-gauge vitrectomy.
abstract: OBJECTIVE
  The purpose of this study was to describe outcomes, trends, risk factors, and protective factors for intraocular pressure (IOP) spikes in patients undergoing 23-gauge pars plana vitrectomy.
  
  
  METHODS
  A retrospective review in an academic institution was performed on all eyes undergoing 23-gauge vitrectomy with at least 1-month follow-up. The main outcome measures included IOP and operative complications.
  
  
  RESULTS
  Ninety-seven eyes of 93 patients were included. Intraocular pressure spikes >22 in the first month occurred in 73% of eyes with or suspect for glaucoma versus 46% of eyes without (P = 0.017); 76% of eyes with a gas fill versus 44% of eyes with a fluid fill (P = 0.0036); and 21% of eyes started on IOP-lowering drops on postoperative day 1 versus 49% of eyes who were not (P = 0.0033). Complications included retinal tears (3%), intraoperative retinal detachment (2%), and postoperative retinal detachment (2%). Fifteen percent of eyes required suturing of at least one sclerotomy. There were no cases of postoperative hypotony or endophthalmitis.
  
  
  CONCLUSIONS
  Patients with or suspect for glaucoma or those with a gas fill may be at risk for high postoperative IOP during the first month. Aggressive early treatment of IOP may prevent IOP spikes in the early postoperative period.
authors.affiliation: Vitreoretinal Division, Kresge Eye Institute, Wayne State University Department of Ophthalmology, Detroit, Michigan 48201, USA.
authors.forename: Christopher N
authors.initials: CN
authors.lastname: Singh
authors.forename: Raymond
authors.initials: R
authors.lastname: Iezzi
authors.forename: Tamer H
authors.initials: TH
authors.lastname: Mahmoud
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005128:Eye Diseases / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D005901:Glaucoma / Q000209:etiology*; D006801:Humans; D007429:Intraocular Pressure / Q000502:physiology*; D008297:Male; D008875:Middle Aged; D015814:Ocular Hypotension / Q000209:etiology*; D011183:Postoperative Complications; D012189:Retrospective Studies; D014821:Vitrectomy / Q000009:adverse effects*