Session Title: Vitreoretinal Surgery V
Session Date/Time: Sunday 20/09/2015 | 11:00-13:00
Paper Time: 11:40
First Author: : V.Lemos PORTUGAL
Co Author(s): : A. Cabugueira J. Cardigos A. Amaral N. Marques J. Branco
PURPOSE:To determine the underlying cause of intraocular pressure (IOP) elevation after rhegmatogenous retinal detachment surgery and risks factors.
Centro hospitalar lisboa central
Materials and methods: A retrospective study of 95 patients were selected with rhegmatogenous retinal detachment that underwent pars plana vitrectomy, PFCL, laser and / or cryotherapy and tamponade with or without scleral indentation. Follow-up postoperative time ≥ 6 months. The best corrected visual acuity (BCVA) was assessed with the Snellen chart and structural success was defined as retinal attached in all four quadrants on fundoscopy performed by a senior retinal surgeon. We also analyzed the following parameters: age, gender, history of glaucoma, diabetes mellitus, hypertension, high myopia (<-6D), functional and structural outcomes, pre and post IOP, pre and postoperative medication and previous ophthalmic surgery.
Results: Surgical mean age of our sample was 59.6 ± 16.1 years, the majority are male (64.6%) with a mean postoperative follow-up of 18.4 ± 6.5 months. There was a significant improvement in the mean postoperative BCVA 0.3 ± 0.3 (p < 0.05). The postoperative complications were recorded. IOP elevation was defined as IOP ≥21 mm Hg and/or a change from baseline of ≥5 mm Hg after surgery. IOP increased in 44,7% of the sample. Approximately 32% of eyes with SF6 and 67% with silicone experienced an increase in intraocular pressure (p < 0.05). 38% of the patients submitted to scleral buckling had increased IOP. The mean number of antiglaucoma drugs increased postoperatively (p<0.05).
Conclusions: In our study, usually secondary glaucoma, which develops after scleral buckling procedures, or pars plana vitrectomy for repair of rhegmatogenous retinal detachment, is of multifactorial origin. It is essential, for appropriate management, to detect the cause of outflow obstruction. Adjusting the tamponade gas concentration might minimize the incidence of this complication.