Secondary Glaucoma as a Complication of Pars Plana Vitrectomy in an Eye Care Centre in Indonesia

Abstract

Aim: To determine the clinical characteristics of secondary glaucoma after pars plana vitrectomy and the risk factors involved in the pathogenesis of secondary glaucoma following pars plana vitrectomy.

Study Design: Retrospective descriptive study

Duration and Settings of the Study: Data review was conducted from October 2022 to January 2023 in the Cicendo National Eye Hospital.

Methods: Clinical data were obtained from medical records of patients diagnosed with secondary glaucoma after undergoing pars plana vitrectomy from January 2019 until December 2019. Data obtained included gender, age, initial diagnoses, lens status, type of intraocular tamponades, types and onset of secondary glaucoma, and intraocular pressure (IOP) of the first and last visit of each patient in the glaucoma unit.

Results: A total of 102 patients were diagnosed with secondary glaucoma out of 1792 patients who underwent pars plana vitrectomy. Out of which 74 (72.5%) were male. Mean age was 49.54 ± 12.35 years. Most of the patients (76.4%) had a rhegmatogenous retinal detachment as an indication for vitrectomy. Phakia was the dominant lens status of the study, observed in 74 patients (72.5%). Vitrectomy with silicone oil constituted the most frequently performed procedure (74.5%). Silicone oil 1300 cSt was the most predominant tamponade employed in 48 patients (47.1%). Open-angle secondary glaucoma was the most prevalent in this study, seen in 90 patients (88.2%). Secondary glaucoma was commonly diagnosed within 1 week to 3 months post-op (64.7%).

Conclusions: Secondary glaucoma is a common complication following pars plana vitrectomy, generally presenting as an open-angle glaucoma. Secondary glaucoma can develop in both early and late postoperative periods, often linked to the tamponade agents employed. The natural crystalline lens demonstrates a protective mechanism against secondary glaucoma.