Risk of Glaucoma after Pars Plana Vitrectomy in a Large Federated Health Record Network.

Purpose: To examine the risk of glaucoma after pars plana vitrectomy (PPV). Design: We conducted a retrospective cohort study using aggregate electronic health record data from the large, federated TriNetX network. Subjects: We identified a retrospective cohort of 42 242 patients from 67 health care organizations in the United States who underwent PPV based on Current Procedural Terminology (CPT) codes from the period between January 1, 2013 and December 31, 2018 and identified subcohorts based on preoperative diagnoses of epiretinal membrane, macular hole, tractional retinal detachment, and rhegmatogenous retinal detachment. Methods: Among these patients, we identified patients who were newly diagnosed with glaucoma after PPV based on International Classification of Diseases, Tenth Revision codes, those who required topical intraocular pressure (IOP)-lowering medications after PPV, and those who required incisional glaucoma surgery based on CPT codes, in the postoperative period between 3 months and 5 years after surgery. Main Outcome Measures: Five-year cumulative risk of new diagnosis of glaucoma, of initiation of topical IOP-lowering medications, or of need for incisional glaucoma surgery (i.e., glaucoma drainage implant or trabeculectomy); Kaplan-Meier probability of being diagnosed with glaucoma or of requiring topical IOP-lowering medications. Results: In our retrospective cohort, >5% of patients who underwent PPV were newly diagnosed with glaucoma and >9% newly required topical IOP-lowering medications in the 5-year period after surgery. Patients with a preoperative diagnosis of rhegmatogenous or tractional retinal detachment had a significantly higher risk of glaucoma compared with those with a preoperative diagnosis of epiretinal membrane or macular hole (P < 0.001). Conclusion: We estimate that the risk of glaucoma in patients after PPV is >5%. It is important to monitor for the development of ocular hypertension or glaucoma in patients after PPV, so they can receive treatment if necessary to prevent further vision loss. Financial Disclosures: Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.