Management of Secondary Glaucoma Postscleral Buckle Surgery: A Tertiary Hospital Experience in Southwest Nigeria

Abstract

Purpose: To evaluate the rate of postoperative intraocular pressure (IOP) elevation and its management in patients who have undergone scleral buckle surgery as a primary intervention for retinal detachment. MATERIALS AND METHODS: This was a retrospective review of hospital files of scleral buckle surgeries for retinal detachment from January 2016 to December 2021 at the University College Hospital Ibadan. All patients with a previous history of glaucoma, vitreoretinal surgery, or a combination of vitrectomy and scleral buckling procedures were excluded from the review. An IOP of ≥22 mmHg after surgery was considered elevated. Results: A total of 148 patients’ charts were reviewed with 125 patients (131 eyes) included in the study. There were 81 males (64.8%) and the mean age of patients was 45.2 (±18.8) years, with a range of 5–81 years. Rhegmatogenous retinal detachment accounted for 97.7% (128 eyes) of all cases and 118 eyes (90.1%) were recent detachments. Seventy-nine eyes (60.3%) recorded elevated IOP postscleral buckle surgery. The mean elevated IOP postbuckle surgery was 27.9 (±6.2) mmHg and the mean antiglaucoma medications prescribed was 2.4 (±2) with a range of 2–5 medications. Four eyes (5.1%) needed surgical intervention for the elevated IOP. The last follow-up mean IOP was 14.3 (±4.1) mmHg. Conclusion: Elevated IOP frequently complicates scleral buckle procedure and medical treatment is usually sufficient. As a common complication, this should be considered in advance when planning for the procedure, especially in low-income countries like Nigeria where scleral buckling surgery is still in common practice.

Keywords

• scleral buckle surgery
• secondary glaucoma
• retinal detachment