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Japanese Journal of Ophthalmology

, Volume 57, Issue 1, pp 57–62 | Cite as

Long-term intraocular pressure changes after combined phacoemulsification, intraocular lens implantation, and vitrectomy

  • Yuya Ki-I
  • Takehiro Yamashita
  • Akinori Uemura
  • Taiji SakamotoEmail author
Clinical Investigation

Abstract

Purpose

To observe long-term changes in intraocular pressure (IOP) after a combined phacoemulsification, intraocular lens implantation, and vitrectomy procedure.

Methods

This was a retrospective case series at a single hospital. Of 105 consecutive cases that received combined phacoemulsification, intraocular lens implantation, and vitrectomy for macular hole or epiretinal membrane, 85 eyes (patients) were followed up for 1 year or longer. The IOP of both eyes in the subjects who had surgery in one eye was measured at baseline and at 1, 3, 6, 12, 24, 36, 48, and 60 months postoperatively. The IOP of the treated eye was compared with the fellow eye and with the baseline value at each follow-up visit.

Results

Intraocular pressure in the operated eyes at 3 months after surgery was significantly lower than that at baseline and than that in the respectively fellow eyes (P < 0.001, paired-t test with Bonferroni correction). The IOP subsequently returned to the baseline value or was the same as that of the fellow eye within 3 months of the observation time point. Only two treated eyes had elevated IOP exceeding 21 mmHg after 6 months postoperatively.

Conclusions

The change in the IOP after phacovitrectomy may be limited, and care when using this procedure because some eyes show increased IOP compared to the fellow eye after a long period.

Keywords

Cataract surgery Pars plana vitrectomy Intraocular pressure Intraocular lens implantation Phacovitrectomy 

Notes

Acknowledgments

This study was supported in part by a Grant from the Research Committee on Chorio-retinal Degeneration and Optic Atrophy, Ministry of Health, Labor, and Welfare, and by a Grant-in-Aid for Scientific Research from the Ministry of Education, Science, and Culture of the Japanese Government.

Conflict of interest

None.

References

  1. 1.
    Demetriades AM, Gottsch JD, Thomsen R, Azab A, Stark WJ, Campochiaro PA, et al. Combined phacoemulsification, intraocular lens implantation, and vitrectomy for eyes with coexisting cataract and vitreoretinal pathology. Am J Ophthalmol. 2003;135:291–6.PubMedCrossRefGoogle Scholar
  2. 2.
    Watanabe A, Shibata T, Ozaki M, Okano K, Kozaki K, Tsuneoka H. Change in anterior chamber depth following combined pars plana vitrectomy, phacoemulsification, and intraocular lens implantation using different types of intraocular lenses. Jpn J Ophthalmol. 2010;54:383–6.PubMedCrossRefGoogle Scholar
  3. 3.
    Weinberg RS, Peyman GA, Huamonte FU. Elevation of intraocular pressure after pars plana vitrectomy. Albrecht Von Graefes Arch Klin Exp Ophthalmol. 1976;200:157–61.PubMedGoogle Scholar
  4. 4.
    Hasegawa Y, Okamoto F, Sugiura Y, Okamoto Y, Hiraoka T, Oshika T. Intraocular pressure elevation in the early postoperative period after vitrectomy for rhegmatogenous retinal detachment. Jpn J Ophthalmol. 2012;56:46–51.PubMedCrossRefGoogle Scholar
  5. 5.
    Aaberg TM, Van Horn DL. Late complication of pars plana vitrectomy surgery. Ophthalmology. 1978;85:126–40.PubMedGoogle Scholar
  6. 6.
    Nguyen QH, Lloyd MA, Heuer DK, Baerveldt G, Minckler DS, Lean JS, et al. Incidence and management of glaucoma after intravitreal silicone oil injection for complicated retinal detachments. Ophthalmology. 1992;99:1520–6.PubMedGoogle Scholar
  7. 7.
    Chen CJ. Glaucoma after macular hole surgery. Ophthalmology. 1988;105:94–100.CrossRefGoogle Scholar
  8. 8.
    Tranos P, Asaria R, Aylward W, Sullivan P, Franks W. Long term outcome of secondary glaucoma following vitreoretinal surgery. Br J Ophthalmol. 2004;88:341–3.PubMedCrossRefGoogle Scholar
  9. 9.
    Desai UR, Alhalel AA, Schiffman RM, Campen TJ, Sundar G, Muhich A. Intraocular pressure elevation after simple pars plana vitrectomy. Ophthalmology. 1997;104:781–6.PubMedGoogle Scholar
  10. 10.
    Chang S. LXII Edward Jackson lecture: open angle glaucoma after vitrectomy. Am J Ophthalmol. 2006;141:1033–43.PubMedCrossRefGoogle Scholar
  11. 11.
    Shingleton BJ, Gamell LS, O’Donoghue MW, Baylus SL, King R. Long-term changes in intraocular pressure after clear corneal phacoemulsification: normal patients versus glaucoma suspect and glaucoma patients. J Cataract Refract Surg. 1999;25:885–90.PubMedCrossRefGoogle Scholar
  12. 12.
    Hudovernik M, Pahor D. Intraocular pressure after phacoemulsification with posterior chamber lens implantation in open-angle glaucoma. Klin Monatsbl Augenheilkd. 2003;220:835–9.PubMedCrossRefGoogle Scholar
  13. 13.
    Lai JS, Tham CC, Chan JC, Lam DS. Phacotrabeculectomy in treatment of primary angle-closure glaucoma and primary open-angle glaucoma. Jpn J Ophthalmol. 2004;48:408–11.PubMedGoogle Scholar
  14. 14.
    Jahn CE. Reduced intraocular pressure after phacoemulsification and posterior chamber intraocular lens implantation. J Cataract Refract Surg. 1997;23:1260–4.PubMedGoogle Scholar
  15. 15.
    Radius RL, Schultz K, Sobocinski K, Schultz RO, Easom H. Pseudophakia and intraocular pressure. Am J Ophthalmol. 1984;97:738–42.PubMedGoogle Scholar
  16. 16.
    Yamakiri K, Sakamoto T, Noda Y, Nakahara M, Ogino N, Kubota T, et al. Reduced incidence of intraoperative complications in a multicenter controlled clinical trial of triamcinolone in vitrectomy. Ophthalmology. 2007;114:289–96.PubMedCrossRefGoogle Scholar
  17. 17.
    Meyer MA, Savitt ML, Kopitas E. The effect of phacoemulsification on aqueous outflow facility. Ophthalmology. 1997;104:1221–7.PubMedGoogle Scholar
  18. 18.
    Steuhl KP, Marahrens P, Frohn C, Frohn A. Intraocular pressure and anterior chamber depth before and after extracapsular cataract extraction with posterior chamber lens implantation. Ophthalmic Surg. 1992;23:233–7.PubMedGoogle Scholar
  19. 19.
    Althaus C, Demmer E, Sundmacher R. Anterior capsular shrinkage and intraocular pressure reduction after capsulorhexis. Ger J Ophthalmol. 1994;3:154–8.PubMedGoogle Scholar
  20. 20.
    Lalezary M, Kim SJ, Jiramongkolchai K, Recchia FM, Agarwal A, Sternberg P Jr. Long-term trends in intraocular pressure after pars plana vitrectomy. Retina. 2011;21:679–85.Google Scholar
  21. 21.
    Yu AL, Brummeisl W, Schaumberger M, Kampik A, Welge-Lussen U. Vitrectomy does not increase the risk of open-angle glaucoma or ocular hypertension—a 5-year follow-up. Graefes Arch Clin Exp Ophthalmol. 2010;248:1407–14.PubMedCrossRefGoogle Scholar
  22. 22.
    Kahn MG, Giblin FJ, Epstein DL. Glutathione in calf trabecular meshwork and its relation to aqueous humor outflow facility. Invest Ophthalmol Vis Sci. 1983;24:1283–7.PubMedGoogle Scholar
  23. 23.
    Siegfried CJ, Shui YB, Holekamp NM, Bai F, Beebe DC. Oxygen distribution in the human eye: relevance to the etiology of open-angle glaucoma after vitrectomy. Invest Ophthalmol Vis Sci. 2010;51:5731–8.PubMedCrossRefGoogle Scholar
  24. 24.
    Barbazetto IA, Liang J, Chang S, Zheng L, Spector A, Dillon JP. Oxygen tension in the rabbit lens and vitreous before and after vitrectomy. Exp Eye Res. 2004;78:917–24.PubMedCrossRefGoogle Scholar
  25. 25.
    Holekamp NM, Shu YBi, Beebe DC. Vitrectomy surgery increases oxygen exposure to the lens: possible mechanism for nuclear cataract formation. Am J Ophthalmol. 2005;139:302–10.PubMedCrossRefGoogle Scholar
  26. 26.
    McNulty R, Wang H, Mathias RT, Ortwerth BJ, Truscott RJ, Bassnett S. Regulation of tissue oxygen levels in the mammalian lens. J Physiol. 2004;559:883–98.PubMedGoogle Scholar
  27. 27.
    Nguyen KP, Chung ML, Anderson PJ, Johnson M, Epstein DL. Hydrogen peroxide removal by the calf aqueous outflow pathway. Investig Ophthalmol Vis Sci. 1988;29:976–81.Google Scholar
  28. 28.
    Podos S, Minas T, Moori F. A new instrument to measure episcleral venous pressure. Arch Ophthalmol. 1986;80:209–11.CrossRefGoogle Scholar
  29. 29.
    Yamashita T, Uemura A, Kita H, Sakamoto T. Analysis of the retinal nerve fiber layer after indocyanine green-assisted vitrectomy for idiopathic macular holes. Ophthalmology. 2006;113:280–4.PubMedCrossRefGoogle Scholar
  30. 30.
    Welch JC. Dehydration injury as a possible cause of visual field defect after pars plana vitrectomy for macular hole. Am J Ophthalmol. 1997;124:698–9.PubMedGoogle Scholar
  31. 31.
    Imai H, Ohta K. Microperimetric determination of retinal sensitivity in areas of dissociated optic nerve fiber layer following internal limiting membrane peeling. Jpn J Ophthalmol. 2010;54:435–40.PubMedCrossRefGoogle Scholar
  32. 32.
    Arima T, Uemura A, Otsuka S, Doi N, Nakao K. Macular hole surgery-associated peripheral visual field loss. Jpn J Ophthalmol. 1998;42:476–83.PubMedCrossRefGoogle Scholar
  33. 33.
    Almubrad TM, Ogbuehi KC. On repeated corneal applanation with the Goldmann and two non-contact tonometers. Clin Exp Optom. 2010;93:77–82.PubMedCrossRefGoogle Scholar

Copyright information

© Japanese Ophthalmological Society 2012

Authors and Affiliations

  • Yuya Ki-I
    • 1
    • 2
  • Takehiro Yamashita
    • 1
  • Akinori Uemura
    • 1
    • 2
  • Taiji Sakamoto
    • 1
    Email author
  1. 1.Department of OphthalmologyKagoshima University Graduate School of Medical and Dental SciencesKagoshimaJapan
  2. 2.Kagoshima City HospitalKagoshimaJapan

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