The use of topical aqueous suppressants in the prevention of postoperative intraocular pressure elevation after pars plana vitrectomy with long-acting gas tamponade

Objective: To determine whether topical aqueous suppressant therapy applied after pars plana vitrectomy with gas tamponade prevents postoperative intraocular pressure (IOP) elevation. Design: Prospective, nonrandomized comparative study. Participants: Forty-one patients who met inclusion criteria and underwent pars plana vitrectomy with gas tamponade (SF₆ 18%-20% or C₃F₈ 12%-16%) over a 1-year period. Intervention: Treatment eyes received topical aqueous suppressants at the end of surgery. Main Outcome Measures: Postoperative IOP at 4 to 6 hours, 1 day, and 1 week. Results: Twenty-one control and 20 treatment eyes met the inclusion criteria. The IOP (in mmHg) measured at 4 to 6 hours (23.05 [control], 14.73 [treatment]) and 1 day (23.24 [control], 17.28 [treatment]) postoperatively showed a statistically significant difference between the groups (P = 0.0038) at 4 to 6 hours and a trend toward significance (P = 0.057) at 1 day. Eleven control and three treatment eyes had an IOP spike above 25 mmHg at 4 to 6 hours or 1 day postoperatively (P = 0.02), and six control eyes and one treatment eye had postoperative IOP greater than 30 mmHg. A pressure rise greater than 40 mmHg was seen in two control eyes and no treatment eyes. Conclusions: Use of topical aqueous suppressants after pars plana vitrectomy with long-acting gas tamponade is effective in preventing significant postoperative IOP elevation in most cases. (C) 2000 by the American Academy of Ophthalmology.