Secondary glaucoma following vitreo-retinal surgeries

Area of Science:

• Ophthalmology
• Retina and Vitreous Surgery
• Glaucoma Management

Background:

• Vitreoretinal surgeries, including scleral buckles and tamponades, frequently elevate intraocular pressure (IOP).
• Glaucoma is a common complication following vitreoretinal procedures, even with advanced surgical methods.
• Intravitreal injections (IVT) of steroids or anti-VEGF agents can also significantly raise IOP, particularly in predisposed glaucomatous eyes.

Purpose of the Study:

• To review the mechanisms causing secondary glaucoma after vitreoretinal surgery.
• To highlight diagnostic challenges and differentiate between various causes of elevated IOP.
• To discuss management strategies for refractory glaucoma post-vitreoretinal surgery.

Main Methods:

• Literature review of mechanisms leading to secondary glaucoma post-vitreoretinal surgery.
• Analysis of diagnostic challenges including clinical features, conjunctival scarring, and episcleral hardware.
• Discussion of IOP-altering effects of intravitreal injections (steroids, anti-VEGF).

Main Results:

• Vitreoretinal surgery and IVT injections are significant risk factors for secondary glaucoma.
• Distinguishing the cause of elevated IOP is critical for appropriate glaucoma management.
• Surgical management of glaucoma in these eyes is complicated by scarring and hardware.

Conclusions:

• Secondary glaucoma following vitreoretinal surgery requires careful diagnosis and tailored management.
• Anti-VEGF agents may impact IOP, necessitating monitoring in glaucoma patients.
• Newer surgical options and modifications are being explored for refractory cases.