Incidence and Risk Factors of Elevated Intraocular Pressure Following Vitrectomy Surgery in Rhegmatogenous Retinal Detachment in a Tertiary Hospital in Northern Malaysia

Abstract

Purpose The purpose of this study was to determine the incidence and factors associated with early postoperative elevated intraocular pressure (IOP) following pars plana vitrectomy (PPV) for rhegmatogenous retinal detachment (RRD) at a tertiary hospital. Methods A single-centre retrospective observational study included 294 adults (aged ≥18 years) who underwent PPV with intraocular gas tamponade for RRD at Hospital Raja Permaisuri Bainun Ipoh between 2017 and 2023. Patients with pre-existing glaucoma, ocular hypertension, who had previous vitreoretinal surgery or silicone oil tamponade were excluded. IOP was measured at two to six hours, one week, and one month postoperatively and defined as elevated when IOP > 20 mmHg. Demographic data and surgical parameters were collected and analysed using Pearson's chi-square and multiple logistic regression analyses to identify independent potential risk factors. Results A total of 98 eyes (33.3%) developed elevated IOP within one month postoperatively, peaking at one week (51.0%). Patients who were younger (<50 years) (OR: 3.19, 95% CI: 1.71, 5.93, p < 0.001), Chinese ethnicity (OR: 5.56, 95% CI: 1.71, 18.02, p = 0.004), and pseudophakic/aphakic status (OR: 2.16, 95% CI: 1.02, 4.58, p = 0.044), and absence of proliferative vitreoretinopathy (PVR) (OR: 1.83, 95% CI: 1.07, 3.13, p = 0.028) had statistical significance in IOP elevation. Gas tamponade type, postoperative lens status, surgery type, vitrectomy gauge, surgeon experience, and concomitant scleral buckle use had no statistical difference. Conclusion Elevated IOP occurred in one-third of eyes following PPV for RRD. Potential risk factors included younger age, Chinese ethnicity, pseudophakic or aphakic status, and absence of PVR. Early recognition of these factors may help prevent unwanted optic nerve damage, thus preventing potential vision loss.