Intraocular pressure variations in rhegmatogenous retinal detachment: Does it point towards an alternate biomechanical response?

Objective: To evaluate the variations in intraocular pressure and its relation with the severity and chronicity of Rhegmatogenous retinal detachment (RRD), as well as the type of break and presence of myopia. Methods: Design: A descriptive cross-sectional study; sample size 75 (4 pq/d2); duration 1 year; exclusion-combined Retinal Detachment (RD), exudative Rd, associated choroidal detachment, and anterior Proliferative vitreoretinopathy (PVR). Parameters considered were age, duration, IOP by Applanation Tonometry (AT), severity, chronicity, PVR changes, location, number of breaks, and presence of myopia. Results: In all, 72% ( n = 54) were males; 25 (33%) patients had features of chronicity (PVR, demarcation line, and atrophic retina). Fifty-one patients (68%) had subtotal RD; Superotemporal quadrant rhegma was present in 30 patients (40%). Normal IOP on AT was observed in 42.7%, lower intraocular pressure (IOP) in 37.3%, and hypotony in 20%. Hypotony was more common among total RRD ( P = 0.027). None showed evidence of globe distortion. The mean duration of RRD was more among those with total RRD ( P = 0.008) and among those with unidentified breaks ( P = 0.031). The mean IOP among the total RRD was 9.42 mm Hg (standard deviation [SD] = 3.69, P = 0.011. The mean IOP showed a negative correlation with the duration among those with fresh RD ( P = 0.041), and the presence of HST ( P = 0.014). The mean IOP showed a positive correlation with age among RRD with features of chronicity ( P = 0.012). Conclusion: The relationship of intraocular pressure dynamics with the severity, chronicity, and type of breaks suggests the possibility of an alternate hypothesis for lower IOP in RRDs.