Comparative assessment of the potential impact of chronic herpesvirus infection on intra- and postoperative complications in patients with glaucoma

Abstract

PURPOSE. To evaluate the potential impact of herpesvirus infection (carriage) on early postoperative outcomes of antiglaucoma surgeries.MATERIAL AND METHODS. The study included 95 patients with stage I, II and III primary open-angle glaucoma (POAG), with indications for surgical treatment. The patients were divided into the main group (group 1, 31 patient) and the control group (group 2, 64 patients). The groups were formed on the basis of information obtained from the anamnesis about a transferred herpes simplex virus of any localization (as a rule, it was labial, oral-facial herpes and its skin manifestation). The indication for surgical treatment was the absence of persistent normalization of intraocular pressure and a decrease in visual functions. Depending on the clinical situation, patients underwent one of the two types of surgical interventions: trabeculectomy and non-penetrating deep sclerectomy. Analysis of postoperative complications was performed on day 7 after surgery.RESULTS. The most frequent complications in the early postoperative period were ciliochoroidal detachment, hyphema, increased intraocular pressure, shallow anterior chamber syndrome, excessive vascularization in the surgery site, clinical signs of conjunctival-scleral and sclerascleral scarring. On day 7 after antiglaucoma surgery, the IOP level was 9.1±0.8 mm Hg on average in the groups. IOP was 1–2 mm Hg higher in case of non-penetrating surgery. In the same patients, normalization of IOP by the same date was obtained in 63.15% of cases, which required goniopuncture; needling was indicated and performed in 84.2% of patients. Ciliochoroidal detachment was diagnosed in both groups with the same frequency: 9.7 and 9.4%, respectively. Presence of minor hyphema was observed only after trabeculectomy, in 16.1 and 10.9% of cases, respectively.CONCLUSION. Results of this study, firstly, do not indicate that HSV activates in response to surgical intervention; secondly, in patients who had been infected with it previously, only a tendency for the number of most common intra- and postoperative complications to increase was noted. The obtained results are insufficient for an unambiguous answer to the question posed in this study, which indicates the need for further research.