Incidence and outcomes of ocular hypertension from rhegmatogenous retinal detachment surgery in the acute postoperative setting

Abstract

Purpose

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

Acknowledgment

The authors would like to thank the Department of Ophthalmology and Visual Sciences of the Philippine General Hospital for their support in accomplishing this work.

Disclosure

The authors report no conflicts of interest in this work.