Risk factors for decompression retinopathy after glaucoma surgery.

Abstract:

PURPOSE:To evaluate the risk factors for decompression retinopathy after glaucoma surgery. METHODS:We reviewed the medical records of patients who underwent a trabeculectomy or Ahmed valve implantation and divided them into 2 groups by the development of decompression retinopathy. Various factors were compared between the 2 groups, including age, sex, glaucoma type, previous intraocular surgery, preoperative and postoperative intraocular pressure (IOP), refractive error, axial length, anesthesia, and systemic risk factors such as history of diabetes, hypertension, medication, and a laboratory examination including hemoglobin, hematocrit, platelet, prothrombin time (PT), and activated partial thromboplastin time (aPTT). RESULTS:The proportion of eyes with decompression retinopathy was 3.05% (21 of 688 eyes), and 50 control eyes were selected randomly. No significant differences were observed between the 2 groups in age, systemic disease, glaucoma type, anesthesia, or the incidence rate of postoperative hypotony. Preoperative maximum IOP and the change of IOP was higher (P=0.016, 0.019), PT and aPTT was prolonged (P=0.001, 0.006), and hemoglobin and hematocrit level was lower in patients with decompression retinopathy (P=0.005, 0.002). Preoperative maximum IOP and hemoglobin showed a significant association with the development of decompression retinopathy in a multivariate analysis (P=0.031, 0.040). No significant difference was observed between the 2 groups for IOP and visual acuity 6 months postoperatively. CONCLUSIONS:Patients with high preoperative IOP and hematologic abnormalities have a higher risk for developing decompression retinopathy. Surgeons should carefully assess the potential risks and pay close attention to sufficiently decrease IOP preoperatively.

journal_name

J Glaucoma

journal_title

Journal of glaucoma

authors

Jung KI,Lim SA,Lopilly Park HY,Park CK

doi

10.1097/IJG.0b013e318287aba0

subject

Has Abstract

pub_date

2014-12-01 00:00:00

pages

638-43

issue

9

eissn

1057-0829

issn

1536-481X

journal_volume

23

pub_type

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