Incidence of Management Changes at the Postoperative Day One Visit After Pars Plana Vitrectomy for Retinal Detachment.

Journal Article (Journal Article)

PURPOSE: To evaluate the incidence of unexpected management changes on the first day after pars plana vitrectomy (PPV) for retinal detachment repair. DESIGN: Retrospective cohort study. METHODS: The medical and billing records of a large academic private practice were electronically queried for all cases of PPV for retinal detachment performed between January 1, 2017, and December 31, 2017. All cases of PPV for rhegmatogenous or tractional retinal detachment with completed postoperative day 1 (POD1) and postoperative week 1 (POW1) visits were included. The preoperative consultation, operative report, and POD1 and POW1 (postoperative days 5-14) visits were reviewed. Main outcome measures were incidence of unexpected management changes (change in or extended positioning, additional procedure, change in drop regimen, or shortened interval follow-up) at the POD1 visit after uncomplicated PPV for retinal detachment. RESULTS: Overall, 418 surgeries from 364 eyes and 355 patients were included. Eleven cases (2.6%) had an intraocular pressure (IOP) over 30 mm Hg at POD1. IOP-lowering drops were prescribed for 30 cases (7.2%). Silicone oil tamponade was positively associated with high IOP at POD1 (relative risk = 3.23, 95% confidence interval 0.96-10.84, P = 0.06). No additional management changes were made besides treating elevated IOP. CONCLUSIONS: Management changes on POD1 after vitrectomy for retinal detachment repair are relatively uncommon and were solely IOP related in this patient group. There may be flexibility regarding the type of POD1 encounter necessary, including an IOP check with an ophthalmic technician or non-retinal eye care provider. Larger, prospective studies are needed to better determine the most efficient follow-up routine.

Full Text

Duke Authors

Cited Authors

  • Patel, D; Borkar, DS; Madhava, M; Obeid, A; Mellen, PL; Regillo, CD; Garg, SJ; Wills Eye Retinal Detachment Study Group,

Published Date

  • February 2021

Published In

Volume / Issue

  • 222 /

Start / End Page

  • 271 - 276

PubMed ID

  • 33002487

Pubmed Central ID

  • PMC7521411

Electronic International Standard Serial Number (EISSN)

  • 1879-1891

Digital Object Identifier (DOI)

  • 10.1016/j.ajo.2020.09.034

Language

  • eng

Conference Location

  • United States