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September 10, 2025Open Access

Effect of pars plana vitrectomy on early and long-term intraocular pressure and its determinants

Key Points

Early ocular hypertension occurred in 28.2% of vitrectomized eyes, with retinal detachment significantly increasing this risk.
Higher preoperative intraocular pressure in fellow eyes predicted both early and late ocular hypertension, suggesting careful preoperative evaluation.
Postoperative intraocular pressure was consistently higher in vitrectomized eyes across all follow-up timepoints, indicating potential long-term complications.
Regular monitoring is crucial to prevent glaucoma in patients undergoing pars plana vitrectomy, particularly those at higher risk.

Abstract

To assess intraocular pressure (IOP) changes and the development of ocular hypertension (OH) following pars plana vitrectomy (PPV), evaluating short- and long-term outcomes and risk factors. This is a retrospective study of 216 patients (432 eyes) who underwent primary unilateral PPV between April 2018 and July 2020, with ≥ 12 months of follow-up. IOP in vitrectomized and fellow eyes was analyzed preoperatively, at 3 months, and at final visit. OH was defined as the need for IOP-lowering medication; IOP was also analyzed as a continuous variable. Baseline and intraoperative factors were evaluated using cohort and matched case-control designs. Median follow-up was 28 months. Early and late OH occurred in 28.2% and 15.3% of vitrectomized eyes. Retinal detachment (RD) increased the risk of early OH fourfold (OR 4.16; p < 0.001). Higher preoperative IOP in the fellow eye predicted both early (OR 1.17; p = 0.003) and late OH (OR 1.18; p = 0.007). Postoperatively, vitrectomized eyes had higher IOP at all timepoints. Glaucoma developed in 6.5% of vitrectomized vs. 1.4% of fellow eyes (p = 0.008). PPV is associated with sustained IOP elevation and increased OH risk. RD and fellow eye IOP are relevant predictors. Long-term monitoring is essential to prevent glaucoma, especially in high-risk patients.

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