Glaucoma associated with the management of rhegmatogenous retinal detachment

Transient or permanent elevation of intraocular pressure (IOP) is a common complication following vitreoretinal surgery. Usually secondary glaucoma, which develops after scleral buckling procedures, or pars plana vitrectomy for repair of rhegmatogenous retinal detachment, is of multifactorial origin...

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Bibliographic Details
Published in:Clinical ophthalmology (Auckland, N.Z.) N.Z.), 2013-01, Vol.7 (default), p.727-734
Main Authors: Mangouritsas, George, Mourtzoukos, Spyridon, Portaliou, Dimitra M, Georgopoulos, Vassilios I, Dimopoulou, Anastasia, Feretis, Elias
Format: Article
Language:English
Subjects:
Care and treatment
Diagnosis
Glaucoma
Health aspects
intraocular pressure elevation
intravitreal gas
Ophthalmology
Retina
Retinal detachment
Review
silicone oil
Vitrectomy
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Summary:Transient or permanent elevation of intraocular pressure (IOP) is a common complication following vitreoretinal surgery. Usually secondary glaucoma, which develops after scleral buckling procedures, or pars plana vitrectomy for repair of rhegmatogenous retinal detachment, is of multifactorial origin. It is essential, for appropriate management, to detect the cause of outflow obstruction. An exacerbation of preexisting open-angle glaucoma or a steroid-induced elevation of IOP should also be considered. Scleral buckling may be complicated by congestion and anterior rotation of the ciliary body resulting in secondary angle closure, which can usually resolve with medical therapy. The use of intravitreal gases may also induce secondary angle-closure with or without pupillary block. Aspiration of a quantity of the intraocular gas may be indicated. Secondary glaucoma can also develop after intravitreal injection of silicone oil due to pupillary block, inflammation, synechial angle closure, or migration of emulsified silicone oil in the anterior chamber and obstruction of the aqueous outflow pathway. In most eyes medical therapy is successful in controlling IOP; however, silicone oil removal with or without concurrent glaucoma surgery may also be required. Diode laser transscleral cyclophotocoagulation and glaucoma drainage devices constitute useful treatment modalities for long-term IOP control. Cooperation between vitreoretinal and glaucoma specialists is necessary to achieve successful management.
ISSN:1177-5467
1177-5483
1177-5483
DOI:10.2147/OPTH.S42792