Glaucoma after vitreoretinal surgery

Abstract

AbstractWith the important advances in the microsurgical techniques during the past three decades, various and complex eye diseases involving retina and vitreous are currently accessible to vitreoretinal surgery. Most current vitreoretinal surgical procedures have major relationships with glaucoma and potential devastating consequences on the optic nerve head. In a pre‐existing glaucoma patient having history of filtering surgery, maintenance of the patency of the filtering bleb requires a vitreoretinal approach for conjunctival preservation with techniques (pneumatic retinopexy or small gauge vitrectomy). Whether coming after intravitreal triamcinolone acetonide injection or associated with panretinal photocoagulation, scleral buckling, pars plana vitrectomy, intraocular gases or silicone oil tamponade, transient or sustained elevation of intraocular pressure and open‐ or closed‐angle secondary glaucomas of a multifactorial nature are a common occurrence following vitreoretinal surgery. Adequate and successful therapeutic intervention should be tailored to the individual patient based on the early identification of the underlying mechanism of the pressure elevation. Patients with or suspect for glaucoma or those who may at risk to develop postoperative ocular hypertension and secondary glaucoma should be carefully screened before any vitreoretinal procedure. This presentation will focus on the different mechanisms, frequency, risk factors, clinical diagnosis and prognosis of ocular hypertension and glaucoma resulting from the different vitreoretinal procedures with their respective available therapeutical options.