Frequency Analysis of Ocular Hypertension after Microinvasive Ultrasonic and Traditional Guillotine Vitrectomy 25G

Purpose. To compare the frequency of ocular hypertension in patients in the early postoperative period after microinvasive ultrasonic and 25G pneumatic guillotine vitrectomy.

Patients and methods. The article presents the results of studying intraocular pressure (IOP) and the frequency of postoperative ophthalmohypertension in patients in the early postoperative period after microinvasive ultrasound and pneumatic guillotine 25G vitrectomy. We analyzed the data of 256 patients (256 eyes) — 158 women, 98 men who underwent vitreoretinal surgery for the pathology of the vitreomacular interface, retinal detachment, diabetic proliferative retinopathy, hemophthalmia at the Optimed, Ufa with a follow-up for 1 month. For tamponade, physiological saline, gas-air mixture, silicone oil, sterile air were used, depending on the nature and severity of vitreoretinal pathology. The mean age was 59.2 ± 12.5 years. In the main group, patients were operated with microinvasive ultrasonic vitrectomy 25G (n = 136), in the control group — using pneumatic guillotine vitrectomy 25G (n = 120). Non-contact tonometry (Nidek Tonoref 3, Japan) was performed with a correction according to measurements of the central thickness of the cornea on a reflective microscope with pachymetry function (Tomey, ЕМ-3000, Japan) before surgery and on days 1, 7, and 30 after vitrectomy. Exclusion criteria from the study were: the presence of symptomatic ophthalmohypertension, glaucoma, traumatic injury to the angle of the anterior chamber, immature and mature cataracts, lens luxation. IOP indicators in both groups at different times of the early postoperative period (days 1, 7, 30) did not differ statistically significantly.

Results. The frequency of ocular hypertension on day 7 in the main group was 20.6 %, in the control group — 20 %, and on day 30 — 11 % and 10 %, respectively (the difference between the groups was not statistically significant, p > 0.05). The highest IOP values were observed with silicone oil tamponade.

Conclusion. The first analysis of the frequency of ocular hypertension in patients after microinvasive ultrasonic vitrectomy 25G did not reveal statistically significant differences with pneumatic guillotine vitrectomy for various types of tamponade.

1. Charles S, Calsada J, Wood B. Microsurgery of the vitreous body and retina. Philadelphia: Lippincott Williams & Wilkins. 2012:169–180.

2. Aznabaev BM, Dibaev TI, Mukhamadeev TR, Vafiev AS, Shavaliev IKh. Twenty five gauge ultrasonic vitrectomy: experimental and clinical performance analysis. Retina. 2020;40(7):1443–1450. doi: 10.1097/IAE.0000000000002863.

3. Wuchinich D. Ultrasonic vitrectomy instrument. Physics Procedia. 2015;63:217– 222. doi: 10.1016/j.phpro.2015.03.035.

4. Stanga PE, PastorIdoate S, Zambrano I, Carlin P,McLeodD. Performance analysis of a new hypersonic vitrector system. Plos One. 2017;12(6):2–3. doi: 10.1371/journal.pone.0178462.

5. Thompson JT. Does vitrectomy increase the risk of glaucoma? Retina. 2011;31:1007– 1008. doi: 10.1097/IAE.0b013e31820d4019.

6. Cabuk KS, Cekic O. Intraocular Pressure Change and Sustained Intraocular Pressure Elevation After Pars Plana Vitrectomy. Beyoglu Eye J. 2021;6(2):96–101. doi: 10.14744/bej.2021.92408.

7. Kornmann HL, Gedde SJ. Glaucoma management after vitreoretinal surgeries. Curr Opin Ophthalmol. 2016;27(2):125–131. doi: 10.1097/ICU.00000000000000238.

8. Fang Y, Long Q, Wang X, Jiang R, Sun X.Intraocular pressure 1 year after vitrectomy in eyes without a history of glaucoma or ocular hypertension. Clin Ophthalmol. 2017;11:2091–2097. doi: 10.2147/OPTH.S144985.

9. Rasin OG, Filipchuk AN, Savchenko AV. Frequency of ophthalmohypertension after vitreoretinal interventions and its correction. Tauride Medical and Biological Bulletin. 2011;14(4):400–401 (In Russ.).

10. Takhchidi KhP, Kazaikin VN, Sosnovskikh VR. Problems and prospects for the use of perfluorocarbons and silicone oils in the treatment of retinal detachment. New in ophthalmology. 2000;1:50–3 (In Russ.)

11. Framme C, Klotz S, WolfSchnurrbusch U, Wiedemann P, Wolf S. Intraocular pressure changes following 20G parsplana vitrectomy. Acta Ophthalmol. 2012;90(8):744–749. doi: 10.1111/j.1755-3768.2011.02251.x.

12. Sdobnikova SB, Sidamonidze AL, Kiseleva TN, Ilyicheva EV, Kravchuk EA, Surguch VK, Sosnovsky VV. The effect of vitrectomy on the hemodynamic parameters of the eye. Ophthalmology. 2007;34–37. (In Russ.).

13. Сдобникова СВ, Сидамонидзе АЛ, Троицкая НА, Сосновский ВВ. Влияние витрэктомии на гидродинамические показатели глаза. Вестник офтальмологии. 2013;1:46–48. Sdobnikova SV, Sidamonidze AL, Troitskaya NA, Sosnovsky VV. The effect of vitrectomy on the hydrodynamic parameters of the eye. Annals of Ophthalmology. 2013;1:46–48. (In Russ.).

14. Tsai JC, Lee MB, WuDunn D, Dacey MP, Choi JC, Minckler DS. Incidence of Acute intraocular pressure elevation after panretinal photocoagulation. Glaucoma. 1995;45–48.

15. Kovacic H, Wolfs RCW, Klllç E, Ramdas WD. The effect of multiple vitrectomies and its indications on intraocular pressure. BMC Ophthalmol. 2019;19:1–7. doi: 10.1186/s12886-019-1187-x.

16. Aykut V, Esen F, Oğuz H. Intraocular Pressure Changes After Pars Plana Vitrectomy for Rhegmatogenous Retinal Detachment. J Retin Vitr. 2020;29:9–15. doi: 10.37845/ret.vit.2020.29.3.

17. Tognetto D, Pastore MR, Cirigliano G, D’Aloisio R, Borelli M, De Giacinto Ch. Longterm intraocular pressure after uncomplicated pars plana vitrectomy for idiopathic epiretinal membrane. Retina. 2019;39:163–171. doi: 10.1097/IAE.0000000000001933.

18. Akdere ÖB, Yücel İ, Yardımsever M, Kaya Hüseyinoğlu B. Intraocular pressure elevation following pars plana vitrectomy and treatment methods. Turkiye Klin J Ophthalmol. 2020;29:44–51. doi: 10.5336/ophthal.2019-65587.

19. Kanclerz P, Grzybowski A. Complications associated with the use of expandable gases in vitrectomy. J Ophthalmol. 2018;86(6):494. doi: 10.1155/2018/8606494.

20. Miele A, Govetto A, Fumagalli C, Donati S, Biagini I, Azzolini C, Rizzo S, Virgili G. Ocular hypertension and glaucoma following vitrectomy: A systematic review. Retina. 2018;38:1–8. doi: 10.1097/IAE.000000000000165120.

21. Movshovich AI, Dzidziguri EA, Gusev SA. Histological changes in the corneal endothelium, retina and pigment epithelium of the rabbit after vitrectomy with ultrasonic phaco fragmentators. Bulletin of Ophthalmology. 1985;6:27–31 (In Russ.).

22. Kornmann HL, Gedde SJ. Glaucoma management after vitreoretinal surgeries. Curr Opin Ophthalmol. 2016;27(2):125–131. doi: 10.1097/ICU.0000000000000238.

23. Hasegawa Y, Okamoto F, Sugiura Y, Okamoto Y, Hiraoka T, Oshika T. Intraocular pressure elevation after vitrectomy for various vitreoretinal disorders. Eur J Ophthalmol. 2014;24(2):235–241. doi: 10.5301/ejo.5000350.

24. Rossi T, Ripandelli G. Pars Plana Vitrectomy and the Risk of Ocular Hypertension and Glaucoma: Where Are We? J Clin Med. 2020;9(12):3994. doi: 10.3390/jcm9123994.