Prognostic value of anterior chamber hemorrhage following glaucoma filtering surgery

Abstract

Evaluation of the prognostic significance of a postoperative anterior chamber hemorrhage (ACH) after glaucoma filtering surgery. Records of 332 patients, who had undergone filtering surgery between 1/1993 and 2/1997, were analyzed retrospectively with particular concern on epidemiologic data, pre- and postoperative regulation of intra-ocular pressure (IOP), complications including ACH, postoperative 5-fluouracil (5-FU) therapy and postoperative IOP lowering therapy. Surgical success was defined as (1) IOP reduction below 21 mm Hg, (2) relative IOP reduction at least 20% and (3) no reoperation to control IOP until the first-year examination. 60 out of 332 patients (18.1%) suffered from ACH after glaucoma filtering surgery. 24 patients with ACH were treated with 5-FU, postoperatively. When all patients with ACH were considered in the evaluation, the difference between the success rate of patients with ACH and the success rate of patients without ACH was not statistically significant. In contrast, when ACH was the only complication in patients, who were not treated with 5-FU, the success rate was significantly worse (38%), when compared with the control group (patients, who did not have ACH or who had other complications in addition to ACH) (67%) (p = 0.008). When patients with these criteria received 5-FU postoperatively, the difference between success rates of both groups was not any longer statistically significant (p = 0.99). The postoperative occurrence of anterior chamber hemorrhage is associated with a higher failure rate of filtering surgery. Early administration of 5-FU is recommended in these cases.