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Abstract #104926 Published in IGR 23-2
Prevalence, characteristics, and outcomes of rhegmatogenous retinal detachment in eyes with trabeculectomy or glaucoma drainage devices
Starr MR; Starr MR; Huang D; Wong JC; Wong JC; Patel LG; Ammar M; Hsu J; Sivalingam A; Mehta S; Ho AC; Kuriyan AE; Khan MA; Cohen MN; Xu D; Lee D; Moster MR; Yonekawa YRetina (Philadelphia, Pa.) 2022; 42: 2039-2045
PURPOSE: To describe the prevalence, management, and outcomes of rhegmatogenous retinal detachment (RRD) following incisional glaucoma filtering surgery. METHODS: All patients with a history of trabeculectomy or glaucoma drainage device (GDI) surgery who were subsequently diagnosed with a RRD from January 1, 2016 to January 1, 2021 at Wills Eye Hospital were identified. RESULTS: Forty-six eyes met the inclusion criteria. The mean age was 60.7 ± 19.6 years and 15 patients (32.6%) were female. Of all eyes, 34 (73.9%) were diagnosed with primary open angle glaucoma. The mean time from most recent incisional glaucoma surgery to RRD diagnosis was 1133 ± 1644 days. There were 19 eyes (41.3%) that had preoperative PVR (9 eyes (19.6%) with grade C PVR) and 33 eyes (76.7%) were macula-off at the time of presentation. At RRD presentation, 4 (8.7%) eyes had concomitant endophthalmitis, 5 (10.9%) had concurrent choroidal detachment, and 2 (4.7%) had concurrent vitreous hemorrhage. Primary vitrectomy was performed in the majority (91.3%) of cases. Silicone oil tamponade was often required (71.1%). The single surgery success rate was 65.2% (30/46). The mean preoperative logMAR visual acuity was 1.72 ± 0.78 (Snellen acuity 20/1050) and the mean final postoperative logMAR was 1.59 ± 0.89 (20/778, p = 0.2853). Of glaucoma surgeries performed, the 5 year prevalence of RRD was 0.71% (26/3664, 95% Poisson Confidence Interval 0.48 - 1.04%). CONCLUSION: The 5 year prevalence of RRDs following trabeculectomy or GDI was 0.71%. Most patients presented with macula-involving detachments, often with PVR. Anatomic and visual outcomes were poor.
Wills Eye Hospital, Mid Atlantic Retina, Thomas Jefferson University, Philadelphia, PA.
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