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Few patients need management changes after pars plana vitrectomy

PHILADELPHIA — One week after pars plana vitrectomy, there were no new retinal breaks, no antibiotic changes made and no need for positional changes in patients undergoing macular surgery, a speaker here said in a presentation on the utility of 1-week clinic visits after PPV.

“More and more, vitreoretinal surgeons are looking at their postoperative practice patterns to see what is actually needed,” Phoebe L. Mellen, MD, said at the annual Wills Eye Conference.

In a retrospective review of 375 patients after uncomplicated PPV for epiretinal membrane and macular hole with normal postoperative day 1 exam, 97.3% had uneventful postoperative week 1 visits without any need for management changes. Ten patients (2.7%) did.

“Most concerning to us was the transient elevation in IOP after PPV,” Mellen said. “No current studies address the short- and long-term effects of transient IOP spikes after vitrectomy.”

Eight patients with IOP spikes — three between 30 mm Hg and 34 mm Hg and five at less than 30 mm Hg — were all given an additional IOP drop at the postoperative week 1 visit.

Of the two remaining patients needing postoperative management changes, one developed hypotony, which necessitated the addition of a steroid, and the other developed cystoid macular edema after epiretinal peeling and was started on an additional nonsteroidal anti-inflammatory. by Patricia Nale, ELS

 

Reference:

Mellen PL. The utility of postoperative week 1 clinic visits after pars plana vitrectomy for macular surgery. Presented at: Wills Eye Conference; March 8 to 10, 2018; Philadelphia.

 

Disclosure: Mellen reports no relevant financial disclosures.

PHILADELPHIA — One week after pars plana vitrectomy, there were no new retinal breaks, no antibiotic changes made and no need for positional changes in patients undergoing macular surgery, a speaker here said in a presentation on the utility of 1-week clinic visits after PPV.

“More and more, vitreoretinal surgeons are looking at their postoperative practice patterns to see what is actually needed,” Phoebe L. Mellen, MD, said at the annual Wills Eye Conference.

In a retrospective review of 375 patients after uncomplicated PPV for epiretinal membrane and macular hole with normal postoperative day 1 exam, 97.3% had uneventful postoperative week 1 visits without any need for management changes. Ten patients (2.7%) did.

“Most concerning to us was the transient elevation in IOP after PPV,” Mellen said. “No current studies address the short- and long-term effects of transient IOP spikes after vitrectomy.”

Eight patients with IOP spikes — three between 30 mm Hg and 34 mm Hg and five at less than 30 mm Hg — were all given an additional IOP drop at the postoperative week 1 visit.

Of the two remaining patients needing postoperative management changes, one developed hypotony, which necessitated the addition of a steroid, and the other developed cystoid macular edema after epiretinal peeling and was started on an additional nonsteroidal anti-inflammatory. by Patricia Nale, ELS

 

Reference:

Mellen PL. The utility of postoperative week 1 clinic visits after pars plana vitrectomy for macular surgery. Presented at: Wills Eye Conference; March 8 to 10, 2018; Philadelphia.

 

Disclosure: Mellen reports no relevant financial disclosures.

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