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

Abstract Purpose To evaluate the incidence of unexpected management changes on the first day after pars plana vitrectomy for retinal detachment repair Design Retrospective cohort study Participants All cases of pars plana vitrectomy (PPV) for rhegmatogenous or tractional retinal detachment with completed postoperative day one (POD1) and week one (POW1) visits were included. 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. The preoperative consultation, operative report, and POD1 and POW1 (postoperative days 5-14) visits were reviewed. Main Outcome Measures 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 mmHg at POD1. IOP lowering drops were prescribed for 30 cases (7.2%). Silicone oil tamponade was positively associated with high IOP at POD1 (RR = 3.23, 95% CI 0.96 –10.84, P = 0.06). No additional management changes were made besides treating elevated IOP. Conclusions Management changes 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.