97th DOG Annual Meeting 1999
GLAUCOMA AFTER PARS PLANA VITRECTOMY AND SILICONE OIL INJECTION
A. Weber, O. Walter, S. Pavlovic, K. W. Jacobi
Temporary or permanent intraocular pressure (IOP) elevation can be expected after pars plana vitrectomy (PPV) and silicone oil injection. It can be caused by different mechanisms including preexisting glaucoma, pupillary block, inflammation or emulsification of silicone oil.
The aim of the study is to determine the incidence and associations of glaucoma after PPV and silicone oil injection.
Methods: A total of 93 eyes operated between 12/1992 and 12/1997 with PPV and silicone oil injection were retrospectively evaluated. The follow up was at least 12 months (12 to 57 month). The indication for silicone oil injection was in 54.8% of the eyes PVR detachment, in 7.5% proliferative diabetic retinopathy, in 10.8% giant tear retinal detachment, in 15.0% penetrating ocular injury, in 11.9% other retinal pathology (e.g. endophthalmitis, subretinal hemorrhage, uveitis, macular hole)
Results: At the time of final postoperative examination in 61.5% of eyes silicone oil was removed. In 79.1% of the eyes retina was completely attached, in 20.9% PVR redetachment existed. In 78% of eyes early postoperatively IOP was normal. Early postoperative glaucoma (defined as IOP elevation >25mmHg) occurred in 18.7% of eyes. In 17.6% the IOP could be regulated with local and/or systemic antiglaucoma medication and in 4.4% IOP elevation persisted despite this therapy. At the time of the final postoperative examination 14.7% of eyes had glaucoma. In 72.8% of them IOP could be regulated with local and/or systemic medication. 8.9% of cases with medically uncontrolled glaucoma underwent glaucoma surgical intervention postoperatively.
Conclusion: Early postoperative glaucoma is a frequent complication after pars plana vitrectomy and silicone oil injection. In 14.7% of eyes IOP elevation persists as a permanent complication. In most of the cases glaucoma could be controlled by local and/or systemic medication. In refractory cases glaucoma surgical intervention is needed.
Department of Ophthalmology, Friedrichstr. 18, D - 35385 Giessen