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Management of glaucoma after retinal detachment surgery
1Bascom Palmer Eye Institute, Miami, Florida 33136, USA. sgedde@med.miami.edu
Current Opinion in Ophthalmology
|March 7, 2002
Summary
Secondary glaucoma can occur after retinal detachment surgery, including scleral buckling and injections of gas or silicone oil. Management may involve medical therapy, laser procedures, or surgical interventions to control intraocular pressure (IOP).
Area of Science:
- Ophthalmology
- Glaucoma Research
- Retinal Surgery
Background:
- Secondary glaucoma is a potential complication following retinal detachment surgery.
- Intraocular pressure (IOP) elevation is frequently observed after scleral buckling and intravitreal injections of gas or silicone oil.
Purpose of the Study:
- To review the mechanisms and management strategies for secondary glaucoma after retinal detachment surgery.
- To highlight challenges in surgical management due to post-operative ocular changes.
Main Methods:
- Review of literature on secondary glaucoma post-retinal detachment surgery.
- Analysis of causes including ciliary body rotation, pupillary block, inflammation, and silicone oil migration.
- Discussion of medical, laser, and surgical treatment options.
Main Results:
- Angle-closure glaucoma post-scleral buckling results from ciliary body congestion and anterior rotation.
- Expansile gases (SF6, C3F8) can cause secondary angle-closure glaucoma, sometimes requiring gas aspiration.
- Silicone oil injection may lead to glaucoma via pupillary block, inflammation, or oil in the anterior chamber.
Conclusions:
- Effective management of secondary glaucoma requires understanding its specific cause post-retinal detachment surgery.
- Prophylactic measures like iridectomy can prevent certain types of glaucoma.
- Treatment may range from medical control to surgical intervention, including oil removal if necessary.