The management of refractory glaucoma after vitreous surgery: A one-year follow-up

Abstract

Objective To examine the effectiveness and safety of 3 kinds of surgeries in eyes with refractory glaucoma following vitrectomy.Methods A retrospective study of a non-comparative case series of 17 eyes of 17 patients who had undergone refractory glaucoma surgery following vitrectomy was conducted from Jan.2008 to Dec.2010.Patients were divided into three groups:group A (5 eyes),patients were treated with trabeculectomy,group B (8 eyes),patients were treated with glaucoma valve implantation,and group C (4 eyes),patients were treated with 810 nm laser transcleral cyclophotocoagulation.Data were analyzed using repeated measure ANOVA.Results All three groups had good control of intraocular pressure (IOP) in nonage after surgery.One year after surgery,the mean IOP of group A was 30.44±4.23 mmHg.Medications were needed to lower IOP in this group.The mean IOP of group B was 20.78±4.54 mmHg,which was considered ideal IOP.The mean IOP of group C was 30.79±3.23 mmHg.The differences were significant (F=32.20,46.81,27.69,P＜0.01),compared to preoperative levels.No serious complications occurred after surgery.Conclusion For refractory glaucoma following vitrectomy,trabeculectomy is less effective over the long term and glaucoma valve implantation is a better treatment method.Treatment with 810 nm laser transcleral cyclophotocoagulation can be useful for blind eyes. Key words: Refractory glaucoma; Vitrectomy; Glaucoma valve devices