Purpose
To determine the presence and relationship between annular cilichoroidal detachment (CCD) and early postoperative intraocular pressure (IOP) in non penetrating deep sclerectomy (NPDS) glaucoma surgery.
Methods
Prospective, observational non-comparative study over thirty two eyes of 32 patients that underwent NPDS. All surgeries were performed with intraoperative antimetabolite agent (mitomycin c 0.2 mg/ ml) and without any intraescleral implant. Patients were examined at 24 hour, 1, 2, 3, 4 and 8 week postoperative follow-up visits by goldman tonometer IOP and swept source optical coherence tomography (SS-OCT). Standarized four sclerolimbar quadrants were analyzed in each visit to detect annular ciliochoroidal detachment with SS-OCT (SS-1000 CASIA; Tomey, Nogoya, Japan). Mean postoperative IOPs were compared between eyes with and without CCD in each visit. Resolution time of CCD reattachment and correlation with factors as: gender, age, type of surgery and corneal pachymetry was also studied.
Results
The incidence of CCD was 53.1% (17 eyes) in the first 24 hour and decreased progressively to 25% (8 eyes) and 6.2% (2 eyes) in 2 week and 4 week examination respectively. The mean postoperative IOPs were significantly lower (p < 0.05) in eyes with annular CCD comparing to eyes without in the 1 and 2 week follow-up ( 9.6 mm Hg Vs 12.8 mm Hg and 9.0 mm Hg Vs 12.4 mm Hg respectively). Mean period of CCD resolution was 17.2 days ( range 3-59 days). In the multivariate analysis a thinner central corneal thickness was the only factor associated to higher incidence of CCD.
Conclusions
SS-OCT technology is a non invasive diagnostic tool aproppriate to monitor presence of annular ciliochoroidal detachment postperatively. Ciliochoroidal detachment was present in 53% of NPDS surgeries in the early postoperative visit. Presence of annular CCD is related with lower postoperative IOP in the first 2 weeks follow-up
Keywords: 550 imaging/image analysis: clinical •
765 wound healing •
632 outflow: ciliary muscle