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

Purpose: To determine if topical aqueous suppressant therapy applied after pars plana vitrectomy (PPV) with gas tamponade successfully prevents postoperative elevation of intraocular pressure (IOP). Methods: A prospective, controlled study was performed on patients who met inclusion criteria and underwent PPV with gas tamponade (SF₆ 18%-20% or C₃F₈ 12%- 16%) over a 1-year period. Treatment eyes received topical aqueous suppressants at the end of surgery. Postoperative IOP checks were performed at 4 to 6 hours, 1 day, and 1 week. Results: Twenty-one control (C) and 20 treatment (T) eyes met the inclusion criteria. The IOP (in mm Hg) measured at 4 to 6 hours (23.05 [C], 14.73 [T]) and 1 day (23.24 [C], 17.28 [T]) postoperatively showed a statistically significant difference between the groups (P =.0038) at 4 to 6 hours, and a trend toward significance (P =.057) at 1 day. Eleven control and 3 treatment eyes had an IOP spike above 25 mm Hg at 4 to 6 hours or 1 day postoperatively (P =.02), and 6 control and 1 treatment eye had a postoperative IOP above 30 mm Hg. A pressure rise above 40 mm Hg was seen in 2 control eyes and no treatment eyes. Conclusions: Use of topical aqueous suppressants following PPV with long-acting gas tamponade is effective in preventing significant postoperative IOP elevation in a majority of cases.