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A. Hagiwara, K. Hirai, G. T. Feke, J. McMeel, T. Hirose; The Scleral Buckling Procedure for Rhegmatogenous Retinal Detachment Is Not a Risk Factor for Open Angle Glaucoma. Invest. Ophthalmol. Vis. Sci. 2008;49(13):5226.
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© ARVO (1962-2015); The Authors (2016-present)
To determine if the scleral buckling procedure (SB) leads to a higher incidence of open angle glaucoma.
The charts of 200 patients (121 male and 79 female, over 18 years old) whose retina had been reattached after a primary SB for rhegmatogenous retinal detachment (RRD) in one eye were retrospectively reviewed. Patients who had SB had no other abnormally except RRD. Follow up period was 1 year or longer. Retinal detachment due to trauma, diabetic retinopathy, or associated with congenital eye diseases was excluded. Glaucoma was diagnosed based on glaucomatous excavation of the optic disc and visual field defects consistent with glaucoma. Glaucoma incidence in the eye receiving SB was compared with that of the fellow eye.
There were 7 eyes (3.5%) with pre-existing glaucoma in eyes receiving SB. Glaucoma was newly detected following SB in 12 eyes (6%). In fellow eyes, there were 8 eyes (4%) with pre-existing glaucoma and 11 eyes (5.5%) with newly found glaucoma. Among these 23 eyes in which glaucoma was newly detected, 10 patients had bilateral glaucoma. The incidence of glaucoma in eyes following SB was 0.58%per year, and the incidence in fellow eyes was 0.54% per year. The difference was not statistically significant. There was a significant difference in IOP between eyes receiving SB and fellow eyes both before and after surgery. Before SB, the mean IOP of the eyes with RRD was 15.2 ± 4.0 mmHg and that of the fellow eyes was 16.5 ± 3.8 mmHg (P<0.001). Three months or longer after surgery, the IOP of the eyes receiving SB was 14.0 ± 2.6 mmHg and that of the fellow eyes was 15.0 ± 2.6 mmHg (P<0.001). There was no significant difference in the incidence of glaucoma with regard to use of an encircling band, intravitreous injection, or subretinal fluid drainage.
The incidence of glaucoma after SB in eyes with RRD was not significantly different from that in the fellow eyes. Eyes receiving SB for RRD were not at increased risk of developing glaucoma. This is one advantage of SB over closed vitrectomy in the treatment of primary retinal detachment. The latter has been estimated to lead to open angle glaucoma in 15% to 20% of eyes.
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