Our Summary

This study aimed to identify the risk factors associated with unexpectedly low eye pressure (hypotony) following a particular type of eye surgery called transconjunctival sutureless vitrectomy (TSV). Researchers looked back at the records of 748 patients who had undergone this surgery and divided them into two groups: those who had low eye pressure after surgery and those who did not.

The results showed that post-operative hypotony occurred in about 16.5% of the patients. Two factors were found to be linked to this: a longer eye length, and not using a technique called tamponade. Also, complications after surgery were more common in the group with low eye pressure (51.1%) compared to the group with normal pressure (11.3%).

The study suggests that for patients with a longer eye length and those not using tamponade, doctors may want to consider a different technique, suturing sclerotomy, to minimize the chance of low eye pressure and related complications after surgery.

FAQs

  1. What is transconjunctival sutureless vitrectomy (TSV)?
  2. What factors were identified as being associated with low eye pressure after TSV?
  3. What alternative technique might doctors consider for patients with longer eye length or those not using tamponade?

Doctor’s Tip

It is important for patients undergoing vitrectomy to follow their doctor’s post-operative instructions carefully, including taking any prescribed eye drops and attending follow-up appointments. If you experience any sudden changes in vision, pain, or unusual symptoms after surgery, it is important to contact your doctor immediately. Your doctor may also recommend certain lifestyle changes to promote healing and prevent complications.

Suitable For

Patients who may be recommended vitrectomy include those with:

  1. Retinal detachment
  2. Macular hole
  3. Diabetic retinopathy
  4. Epiretinal membrane
  5. Vitreous hemorrhage
  6. Vitreomacular traction syndrome
  7. Proliferative vitreoretinopathy
  8. Endophthalmitis
  9. Retinal vein occlusion

It is important for patients to discuss their individual case with their ophthalmologist to determine if vitrectomy is the best treatment option for their specific condition.

Timeline

Before vitrectomy:

  1. Patient undergoes a comprehensive eye examination to determine the need for vitrectomy.
  2. Pre-operative tests such as imaging scans and blood tests are conducted.
  3. Patient receives instructions on pre-operative care, including fasting before surgery.

After vitrectomy:

  1. Patient may experience temporary blurred vision, redness, and discomfort in the eye immediately after surgery.
  2. Follow-up appointments are scheduled to monitor the healing process and check for any complications.
  3. Patient may need to use eye drops or medications to prevent infection and reduce inflammation.
  4. Vision gradually improves over time as the eye heals.
  5. Long-term follow-up may be required to monitor for any late complications such as retinal detachment or cataracts.

What to Ask Your Doctor

Some questions a patient should ask their doctor about vitrectomy, especially in the context of this study, include:

  1. Am I at risk for unexpectedly low eye pressure (hypotony) following vitrectomy, based on my eye length and the technique you plan to use?
  2. What measures will be taken to prevent or minimize the risk of hypotony during and after the surgery?
  3. Is tamponade being considered as part of the surgical technique, and if not, why?
  4. What are the potential complications associated with hypotony after vitrectomy, and how will they be managed if they occur?
  5. Should I consider a different surgical technique, such as suturing sclerotomy, to reduce the risk of low eye pressure and related complications?
  6. What is the overall success rate of vitrectomy for my specific eye condition, and how does the risk of hypotony factor into this success rate?
  7. What post-operative care will be needed to monitor and address any changes in eye pressure after surgery?
  8. Are there any additional factors or considerations specific to my individual case that may affect the risk of hypotony or other complications after vitrectomy?

Reference

Authors: Ando T, Terashima H, Fujii K, Yoshida H, Ueda E, Nozaki Y, Shiozaki N, Yaoeda K, Fukuchi T. Journal: PLoS One. 2025 Apr 28;20(4):e0321135. doi: 10.1371/journal.pone.0321135. eCollection 2025. PMID: 40293984