Impact of Vitreoretinal Procedures on Intraocular Pressure and Its Management: A Comprehensive Review

The intricate anatomical proximity and shared microcirculatory environment of the anterior and posterior segments create a delicate homeostatic balance, rendering both highly susceptible to iatrogenic perturbations. Surgical and post-operative alterations may result in significant hemodynamic and structural changes affecting intra-ocular pressure (IOP) regulation. Among these, post-operative IOP elevation remains one of the most frequent yet often underappreciated complications of vitreoretinal surgery. Its pathogenesis is multifactorial, encompassing structural modifications, post-operative inflammatory responses, and aqueous outflow obstruction. Persistent IOP elevation may compromise retinal perfusion, contribute to optic nerve damage, and adversely affect surgical outcomes. This comprehensive review critically synthesises current evidence on the incidence, mechanisms, risk factors, and current management strategies for IOP elevation following scleral buckling, pars plana vitrectomy, intravitreal gas tamponade, silicone oil endotamponade, and pharmacologic interventions. Emphasis is placed on early recognition, preventive measures, and tailored therapeutic approaches to mitigate sight-threatening sequelae and optimise long-term visual outcomes.