Evaluation of Risk Factors for Glaucoma Development in Patients with Pars Plana Vitrectomy

Abstract

ABSTRACT Objective: To determine the risk factors that may lead to the development of glaucoma in patients undergoing Pars Plana Vitrectomy (PPV) surgery. Material and Methods: Patients who undwent PPV and had a minimum follow-up of 12 months were included in this retrospective study. Intraocular pressure was measured with an applanation tonometer at 1, 6, and 12 months. Patients were divided into two groups as those who developed glaucoma after PPV and those who did not. The two groups were compared based on demographics (age and gender), indication for PPV, presence of intraoperative neovascularization, tamponade type (silicone oil or gas), use of laser photocoagulation, and concurrent phacoemulsification (PHACO). Results: 289 patients were included in the study. While the 1st month IOP value was higher in the glaucoma group (p=0.042), the 6th month, 1st year and last measured IOP values did not show any significant difference between the two groups. The reason for vitrectomy was macular hole in the non-glaucoma group; the rate of retinal detachment (RD) with tears and vitreous hemorrhage due to other causes was significantly higher in the glaucoma group (p<0.05). RD before PPV was detected more in the glaucoma group (p<0.05). There was no difference between the two groups in terms of neovascularization after PPV. There was no difference between the two groups in terms of whether the lens was phakic, pseudophakic or aphakic (p>0.05). The rate of silicone added to PPV in the glaucoma group and the rate of gas added to PPV in the non-glaucoma group were statistically higher (p=0.000). The rate of laser therapy/application was significantly higher in the glaucoma group (p<0.05). Conclusions: Long-term (at least one year) cautious follow-up for glaucoma should be done if PPV was performed because of retinal detachment, if more than one PPV was performed, if silicone or laser was added to PPV, and if complications developed after PPV.

Keywords

• Glaucoma
• Intraocular Pressure
• Pars Plana Vitrectomy

Pars Plana Vitrektomi Yapılan Hastalarda Glokom Gelişimi için Risk Faktörlerinin Değerlendirilmesi

Abstract

ÖZ Amaç: Pars Plana Vitrektomi (PPV) cerrahisi geçiren hastalarda glokom gelişimine neden olabilecek risk faktörlerinin belirlenmesi. Gereç ve Yöntemler: Retrospektif olarak planlanan çalışmaya PPV olan ve en az 12 ay takip süresi bulunan hastalar dahil edildi. Tüm hastaların rutin göz muayeneleri yanında applanasyon tonometresi ile göz içi basınçları ölçülmüştü. Hastalar PPV sonrası glokom gelişen ve gelişmeyen olarak iki gruba ayrıldı. İki grubun demografik verileri, PPV yapılma sebepleri, operasyon sonrası neovaskülarizasyon varlığı, PPV cerrahisinde silikon ya da gaz kullanılması, lazer fotokoagülasyon eklenmesi, PPV ile aynı seansta fakoemülsifikasyon (FAKO) yapılması risk faktörleri olarak incelendi. Bulgular: Çalışmaya 289 hasta dahil edildi. Glokom olan grupta birinci ay göz içi basıncı (GİB) değeri daha yüksekken (p=0.042); altıncı ay, birinci yıl ve son ölçülen GİB değeri iki grup arasında anlamlı farklılık göstermemiştir. Glokom olmayan grupta makula deliği, glokom olan grupta yırtıklı retina dekolmanı ve diğer sebeplere bağlı vitre içi kanama oranı anlamlı olarak daha yüksekti (p<0.05). PPV sonrası neovaskülarizasyon açısından iki grup arasında fark yoktu. İki grup arasında lensin fakik, pseodofakik ya da afakik olması açısından fark saptanmamıştır (p>0.05). Glokom olan grupta silikon tamponadı, glokom olmayan grupta ise gaz tamponadı istatistiksel olarak daha fazlaydı (p=0.000). Glokom olan grupta lazer oranı glokom olmayan gruptan anlamlı olarak daha yüksekti (p<0.05). Sonuçlar: Bu çalışmada PPV sebebinin retina dekolmanı olması, tekrarlayan PPV’ler, cerrahi sırasında silikon ve lazer kullanılması ve cerrahi sonrası komplikasyon meydana gelmesi PPV sonrası glokom gelişimi için risk faktörleri olarak tespit edildi. Bu risk faktörlerinin eşlik ettiği olguların en az bir yıl glokom gelişimi açısından dikkatli takibinin önemli olduğunu düşünmekteyiz.

Keywords

• Glokom
• Göz İçi Basıncı
• Pars Plana Vitrektomi

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