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Choroidal detachment in post trabeculectomy patients in an asian tertiary eye centre
Author(s) -
XU YP,
YIP WLL,
YONG KYV,
LIM BA,
WONG HT,
GAN N
Publication year - 2014
Publication title -
acta ophthalmologica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.534
H-Index - 87
eISSN - 1755-3768
pISSN - 1755-375X
DOI - 10.1111/j.1755-3768.2014.t046.x
Subject(s) - trabeculectomy , medicine , glaucoma , ophthalmology , visual acuity , open angle glaucoma , diabetes mellitus , surgery , endocrinology
Purpose The aim of this study is to identify risk factors that lead to choroidal effusion in post trabeculectomy patients. Methods The clinical notes of all patients who developed choroidal detachment after trabeculectomy for glaucoma between 2000 to 2011 in a tertiary institution were reviewed. Potential risk factors including glaucoma subtype, intraoperative complications, ischemic risk factors, use of anti‐metabolites and post‐operative procedures were analysed as potential risk factors. Results Twenty‐three subjects developed post‐trabeculectomy choroidal detachments. The mean age was 70.8 +/‐ 12 years (range 38 to 86 years old). 17 out of the 23 choroidal detachments were male patients. The most common subtype of glaucoma associated with choroidal detachment was primary open angle glaucoma. 2 patients (8.7%) developed choroidal detachments within 1 week post‐operatively. The hypotony lasted 2 weeks to 48 months with 4 patients (17.4%) requiring revision of the bleb. All patients had adjunctive anti‐metabolites used, with MMC used in 22 cases and 5FU used in 1. 4 patients (17.4%) had diabetes, 6 (26.0%) had hyperlipidemia, 11 (47.8%) had hypertension and 2 (8.7%) were smokers. The mean final visual outcome was 0.30 on the logMAR scale. Conclusion All patients had good visual outcomes. Of the factors analysed, use of anti‐metabolites was the only one found to be associated with development of choroidal detachment post‐trabeculectomy. Vast majority of choroidal detachments occur beyond 2 weeks after surgery and clinicians should continue to monitor these patients carefully.