Secondary Glaucoma After Vitreoretinal Procedures

Abstract

Vitreoretinal surgery can be associated with transient or sustained elevated intraocular pressure (IOP) as a complication. This may occur in the immediate, early and late post operative phase. Secondary glaucoma is a complication of both external procedures (such as scleral buckling) and internal procedures (pars plana vitrectomy) including intravitreal steroids. Several internal tamponade agents are used in vitreoretinal surgery, such as expanding gases and silicone oils which can compromise the aqueous outflow in several ways, resulting in secondary glaucoma. This chapter will look at the causes of secondary glaucoma complicating vitreoretinal procedures. Anderson et al, 2006, looked at 222 patients that underwent vitreoretinal procedures and noted that 8.4% had an IOP >30mmHg at 5-12 hours and 14.9% had an IOP>30mmHg on the first post operative day, despite all patients receiving topical brimonidine tds from 2 hours post operatively.