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Correspondence

Correspondence To the Editor: We read with interest the article “Long-term follow-up of intraocular pressure after vitrectomy in eyes without preexisting glaucoma” by Mi et al, Retina 2015;35:2543–2551. 1 The authors evaluate patients vitrectomized for macular holes/epiretinal membranes and compare changes in intraocular pressure (IOP) over a period of 2 years or more of follow-up. The study mentions an unexplained decrease of IOP in the fellow eyes. We believe that because the patients with disorders such as macular holes/epiretinal membranes include stages of vitreous degeneration and detachment in their pathogenesis, 2 the fellow eyes may also develop these degenerative changes over the period of follow-up. One may expect the eye with degenerative vitreous to behave like a vitrectomized eye, as 98% of normal vitreous being composed of water. Therefore, the fellow eyes may have experienced a decrease in IOP just like the operated eyes for reasons such as lack of formed vitreous support to the lens, 3 although delayed in comparison. The authors report a significant decline, although marginal, of IOP in the operated eyes in early follow-up period (up till 6 months) but not later. The aforementioned reasoning, hence, concords with the results of the study. These results could of course be affected by lenticular changes observed after vitrectomy in the phakic subset. 3 Hence, we suggest optical coherence tomography–based analysis of the fellow eyes for vitreous changes and also evaluation of temporal variation of IOP in phakic eyes. The authors mention using both 20 G and minimal vitrectomy systems for surgery. If the numbers are comparable, comparison between these vitrectomy systems for changes in IOP will also reveal valuable data. We hope our discussion adds to the study, and await the authors ' response. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Retina Wolters Kluwer Health

Correspondence

Azad, Shorya; Takkar, Brijesh
Retina , Volume 36 (7): e67 – Jul 1, 2016
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Publisher
Wolters Kluwer Health
Copyright
Copyright © Retina
Subject
Correspondence
ISSN
0275-004X
eISSN
1539-2864
DOI
10.1097/IAE.0000000000001105
pmid
27276639
Publisher site
See Article on Publisher Site

Abstract

To the Editor: We read with interest the article “Long-term follow-up of intraocular pressure after vitrectomy in eyes without preexisting glaucoma” by Mi et al, Retina 2015;35:2543–2551. 1 The authors evaluate patients vitrectomized for macular holes/epiretinal membranes and compare changes in intraocular pressure (IOP) over a period of 2 years or more of follow-up. The study mentions an unexplained decrease of IOP in the fellow eyes. We believe that because the patients with disorders such as macular holes/epiretinal membranes include stages of vitreous degeneration and detachment in their pathogenesis, 2 the fellow eyes may also develop these degenerative changes over the period of follow-up. One may expect the eye with degenerative vitreous to behave like a vitrectomized eye, as 98% of normal vitreous being composed of water. Therefore, the fellow eyes may have experienced a decrease in IOP just like the operated eyes for reasons such as lack of formed vitreous support to the lens, 3 although delayed in comparison. The authors report a significant decline, although marginal, of IOP in the operated eyes in early follow-up period (up till 6 months) but not later. The aforementioned reasoning, hence, concords with the results of the study. These results could of course be affected by lenticular changes observed after vitrectomy in the phakic subset. 3 Hence, we suggest optical coherence tomography–based analysis of the fellow eyes for vitreous changes and also evaluation of temporal variation of IOP in phakic eyes. The authors mention using both 20 G and minimal vitrectomy systems for surgery. If the numbers are comparable, comparison between these vitrectomy systems for changes in IOP will also reveal valuable data. We hope our discussion adds to the study, and await the authors ' response.

Journal

Retina – Wolters Kluwer Health

Published: Jul 1, 2016

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