Risk factors for the development of glaucoma after vitreoretinal surgery

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Abstract

Purpose

To determine risk factors for the development of glaucoma after vitreoretinal surgery.

Methods

Case-control study. Cases (n=96) were all patients who received a Baerveldt glaucoma implant after vitreoretinal surgery performed between 1991-2011. Controls (n=288) were a random subset of patients who underwent vitreoretinal surgery without subsequent glaucoma surgery. Cases and controls were matched with regard to the year in which the first vitreoretinal intervention was performed. The role of age, sex, number of interventions, type of intervention (plombe or vitrectomy), indication of first intervention, use of silicone oil, preoperative lens status, IOP and IOP lowering medication one week after the first intervention, history of glaucoma or OHT, and a positive family history of glaucoma were analyzed with logistic regression.

Results

Cases were more often men (p=0.03), younger at the moment of the first surgical procedure (p=0.005), underwent more vitreoretinal procedures (p<0.001), had on average a higher mean intraocular pressure (p=0.005) and medication use (p=0.001) 1 week after the first procedure and had more often a history of glaucoma or ocular hypertension (p<0.001). The use of silicone oil became a significant risk factor after removing the number of interventions from the model (p=0.002).

Conclusion

Patients who develop glaucoma after vitreoretinal surgery have a different risk-profile compared to patients who do not develop glaucoma. This gives the opportunity to monitor certain subgroups.

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