Abstract
Abstract: :
Purpose: To determine the clinical characteristics of patients who developed choroidal detachment (CD) following intraocular surgery. Methods: Retrospective series at a tertiary care referral eye center over a 7 year period. Results: In the last 7 years, 22 cases of CD were diagnosed within three months of previous intraocular surgery. The mean time of presentation of CD was 7.5 days (range,0–45 days) after intraocular surgery. The mean age of patients was 63.3 years (range, 9–82 years); 12(54%) were male and 10(46%) female. Racial demographics were as follows: Caucasian, 10(46%); African–American, 8(36%); Hispanic, 2(9%); and others, 2(9%). Types of intraocular surgery performed just prior to the CD included: trabeculectomy with mitomycin (MMC), 5 patients(23%); trabeculectomy with MMC and suture lysis, 2(9%); trabeculectomy and Baerveldt implant, 3(13.7 %); trabeculectomy and Ahmed implant, 1(4.5%); Baerveldt implant, 2(9%); Baerveldt implant with pars plana vitrectomy(PPV) with posterior positioning of the tube, 1(4.5%); extracapsular cataract extraction with intraocular implant, 3(13.7%); intracapsular cataract extraction with anterior vitrectomy, 1(4.5%); penetrating keratoplasty, 2(9%); PPV with pars plana lensenctomy and retinal detachment repair, 1(4.5%); needle revision of failing bleb with 5–fluorouracil injection, 1(4.5%). 15(68%) patients had glaucoma, 10(46%) hypertension, 3(13.7%) coronary artery disease, 3(13.7%) diabetes, 3(13.7%) end stage kidney disease [of which 2 were on hemodialysis], 2(9%) inflammatory bowel disease, 2(9%) arrhythmia, 1(4.5%) cardiomyopathy, and 1(4.5%) cirrhosis with ascites. 17 of 22(77%) patients had undergone more than one previous intraocular surgery prior to the development of CD. In these cases, penultimate surgeries included cataract extraction 14(64%), 4(18%) retinal detachment repair, 4(18%) trabeculectomy and 2(9%) penetrating keratoplasty. Of the 22 patients who developed CD, 10(45%) were serous, 7(32%) were hemorrhagic and 5(23%) were both. 15 of 22 patients required drainage of the choroidals; 7 of them also underwent simultaneous PPV. 3 of the 15 needed repeat drainage of choroidals. Conclusions: The preoperative and intraoperative factors that may be associated with an increased risk of CD after intraocular surgery include hypertension, glaucoma, end stage kidney disease (on dialysis), and additional previous intraocular surgery. Further studies will be needed to determine which of these associations are true risk factors.
Keywords: choroid • clinical (human) or epidemiologic studies: outcomes/complications