Post-Trabeculectomy Choroidal Detachment: Not an Adverse Prognostic Sign for Either Visual Acuity or Surgical Success

Abstract

To report the incidence of choroidal detachment (CD) following trabeculectomy and to evaluate its effect on long-term surgical success and best-corrected visual acuity (BCVA). A total of 253 eyes of 198 subjects who underwent trabeculectomy between 1993 and 2003 with at least 1 year follow-up were reviewed retrospectively. Twenty-eight eyes of 28 subjects which developed CD postoperatively were classified as Group 1 and the remaining 225 eyes of 170 subjects as Group 2. The risk factors for the development of CD and the influence of CD on BCVA and on the success of trabeculectomy were analyzed and compared between the two groups. In Group 1, preoperative BCVA was significantly lower and cup to disc ratio and the frequency of pseudoexfoliative glaucoma were higher with respect to the control group (p=0.009, p=0.01, p=0.02). The correlations between the development of CD and postoperative findings such as shallowing of the anterior chamber, hypotony, hypotonic maculopathy, hyphema, and fibrin reaction in the anterior chamber were statistically significant.CD was not associated with a significant reduction of BCVA. Intraocular pressures at postoperative first day, sixth month, and first year were lower in Group 1. The success of trabeculectomy and the average number of medications used were not significantly different between the two groups. CD following trabeculectomy occurred in 11% of our patients. CD was not associated with either a significant drop in BCVA or an adverse influence on long-term IOP control.