Working Paper Review Version 1 This version is not peer-reviewed

Pars Plana Vitrectomy and the Risk of Ocular Hypertension and Glaucoma: Where Are We?

Version 1 : Received: 27 October 2020 / Approved: 29 October 2020 / Online: 29 October 2020 (10:58:20 CET)

How to cite: MD, T.R.; Ripandelli, G. Pars Plana Vitrectomy and the Risk of Ocular Hypertension and Glaucoma: Where Are We?. Preprints 2020, 2020100608 MD, T.R.; Ripandelli, G. Pars Plana Vitrectomy and the Risk of Ocular Hypertension and Glaucoma: Where Are We?. Preprints 2020, 2020100608

Abstract

Purpose is to o review the pathogenic mechanism for ocular hypertension and glaucoma development after pars plana vitrectomy. Both acute and chronic causes are considered and special attention is paid to the theories and clinical evidence on the risk of developing Open Angle Glaucoma (OAG) after Pars Plana Vitrectomy (PPV). Most existing scientific literature on the issue agree on the role of ascorbate as an oxygen scavenger within the vitreous chamber. Oxygen tension in the vitreous and anterior chamber is maximum inn proximity of the retinal surface and endothelium, respectively and steeply decreases toward the lens; on both sides, and trabeculate. Vitreous removal and, to a lesser extent, liquefaction, greatly reduces oxygen tension gradient in vitreous chamber while cataract extraction has similar effects on anterior chamber oxygen gradients. Oxygen derivatives originated from the cornea and retina are actively reduced by the vitreous gel and/or the crystalline lens. Vitreous removal and cataract extraction reduce drastically this function. Most reported clinical series confirm this hypothesis although protocol difference and follow-up length greatly impact the reliability of results.

Subject Areas

Ascorbate; Pars Plana Vitrectomy; Open Angle Glaucoma; Oxidative Stress; Ocular Hypertension

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