Clinical Ophthalmology (Aug 2019)
Incidence and outcomes of ocular hypertension from rhegmatogenous retinal detachment surgery in the acute postoperative setting
Abstract
Albert John Bromeo, Nilo Vincent FlorCruzDepartment of Ophthalmology and Visual Sciences, Philippine General Hospital, University of the Philippines Manila, Manila, PhilippinesCorrespondence: Albert John BromeoSentro Oftalmologico Jose Rizal, Philippine General Hospital, Taft Avenue, Manila, PhilippinesTel/fax +63 02 554 8400Email [email protected]: To determine the incidence of ocular hypertension following surgery for rhegmatogenous retinal detachment in the first 3 months postoperatively and to determine their outcomes in terms of visual acuity, control of IOP, and changes in cup:disc ratio.Patients and methods: A single center prospective cohort study was done involving patients who underwent retinal surgery for rhegmatogenous retinal detachment. The patients were followed up for 3 months postoperatively and were monitored for development of ocular hypertension. The primary outcome measures were changes in IOP, visual acuity, and cup:disc ratio.Results: Of the 52 eyes enrolled in the study, 19 eyes developed ocular hypertension in the first 3 months postoperatively, giving an incidence rate of 36.5% (95% CI, 48.9–76.0%). Analysis of mean IOP trends shows that most cases of IOP elevations occur in the first day postoperatively with a sustained elevation up to the first month and then returning to normal levels by the 3rd month. There is a significant increase in mean cup:disc ratio among patients who developed ocular hypertension (p=0.047). Visual acuity trends show that mean visual acuity significantly improved from baseline among cases who maintained normal IOP (p=0.002) as compared to those who developed ocular hypertension (p=0.97), although the difference in final visual acuity at the end of 3 months between groups was not statistically significant (p=0.30).Conclusion: Ocular hypertension may complicate retinal reattachment surgery. Control of IOP in the acute setting is essential to prevent development of secondary glaucoma.Keywords: intraocular pressure, ocular hypertension, retinal detachment surgery, secondary glaucoma
