Acute effects of intravitreal aflibercept injections on intraocular pressure in vitrectomized and silicone-oil-filled eyes: a prospective cohort study

This prospective, single-center, single-blind, interventional cohort study compares acute intraocular pressure (IOP) changes following intravitreal aflibercept injections in eyes with different vitreous states. 67 eyes of 58 patients, including vitrectomized eyes with (n = 22) and without silicone oil tamponade (n = 22) and nonvitrectomized eyes (n = 23) were analyzed. Intravitreal aflibercept was administered according to guidelines. IOP was evaluated before and immediately after intravitreal injection (IVI) and at 5, 15, 30, 60, and 180 min, day 1, and week 1 postinjection. IOP measurements were taken with iCare-100 rebound tonometry (RBT) and Goldmann applanation tonometry (GAT). The mean participant age was 62.13 ± 14.06 years (male-to-female ratio, 1.48:1). Postinjection IOP increased to the same levels. IOP curve resolution was similar in all vitreous groups, showing no significant difference at any timepoints. Emulsified silicone oil did not affect the IOP curve. Prior IVI count had some influence on the dynamics of IOP spike resolution but did not affect the initial IOP rise. RBT showed moderate-to-good agreement with GAT, except for extremely elevated IOPs where it appeared less consistent. Intra-silicone and post-vitrectomy administration of aflibercept is safe. RBT may be considered for nonglaucomatous cases as an easy alternative to follow-up postinjection acute IOP changes.