Shantha Balekudaru, Amit Pandey, Parveen Rewri, R George, Lingam Vijaya, Mani Baskaran
{"title":"Clinical associations for the development of malignant glaucoma following intraocular surgery.","authors":"Shantha Balekudaru, Amit Pandey, Parveen Rewri, R George, Lingam Vijaya, Mani Baskaran","doi":"10.4103/IJO.IJO_1609_24","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>To assess the factors associated with malignant glaucoma (MG) following intraocular surgery.</p><p><strong>Design: </strong>Retrospective case-control study.</p><p><strong>Setting: </strong>Institutional.</p><p><strong>Study population: </strong>A total of 40 eyes with MG and 80 controls were included.</p><p><strong>Methods: </strong>A total of 40 patients who developed malignant glaucoma following intraocular surgery between January 1995 and December 2013 were compared with 80 age- and gender-matched controls who underwent surgery during the study period.</p><p><strong>Main outcome measures: </strong>The associated factors for the development of malignant glaucoma following intraocular surgery.</p><p><strong>Results: </strong>Diagnosis in cases included primary angle closure glaucoma (PACG: 31 [77.5%]), primary open-angle glaucoma (POAG: 2 [5%]), pseudoexfoliation glaucoma (PXFG: 4 [10%]); in controls included PACG 44 (55%) and POAG 36 (45%), (P < 0.001). Trabeculectomy was performed in 24 cases (50%) and 28 (35%) controls, phaco-trabeculectomy in 14 cases (35%) and 52 eyes (65%) in controls, and cataract surgery in 2 cases (5%) (P = 0.004). Factors associated on univariate analysis included PACG (odds ratio [OR]: 12.68, 95% confidence interval [CI]; 2.84, 56.62, P < 0.001, synechial angle closure > 180° (OR: 10.1, 95% CI: 2.87, 35.44, P < 0.001, higher preoperative IOP > 22 mmHg (OR: 5.32, 95% CI: 2.64, 10.73, P < 0.001), trabeculectomy (OR: 3.05, 95% CI: 1.36, 6.83, P = 0.007) and axial length < 22 mm (OR: 6.80, 95% CI: 2.51, 18.46, P < 0.001. The use of postoperative cycloplegics was protective on univariate analysis (OR: 0.268, 95% CI: 0.12, 0.596), P < 0.001). Preoperative IOP > 22 mmHg (2.85, 95% CI: 1.11, 7.31, P = 0.02), and trabeculectomy (OR: 4.09, 95% CI: 1.48, 11.3, P = 0.007) remained significant on multivariate analysis.</p><p><strong>Conclusion: </strong>PACG eyes with higher preoperative IOP and eyes undergoing trabeculectomy surgery alone, increased the likelihood of developing MG.</p>","PeriodicalId":13329,"journal":{"name":"Indian Journal of Ophthalmology","volume":"73 Suppl 2","pages":"S240-S243"},"PeriodicalIF":2.1000,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Indian Journal of Ophthalmology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.4103/IJO.IJO_1609_24","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/2/21 0:00:00","PubModel":"Epub","JCR":"Q2","JCRName":"OPHTHALMOLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Purpose: To assess the factors associated with malignant glaucoma (MG) following intraocular surgery.
Design: Retrospective case-control study.
Setting: Institutional.
Study population: A total of 40 eyes with MG and 80 controls were included.
Methods: A total of 40 patients who developed malignant glaucoma following intraocular surgery between January 1995 and December 2013 were compared with 80 age- and gender-matched controls who underwent surgery during the study period.
Main outcome measures: The associated factors for the development of malignant glaucoma following intraocular surgery.
Results: Diagnosis in cases included primary angle closure glaucoma (PACG: 31 [77.5%]), primary open-angle glaucoma (POAG: 2 [5%]), pseudoexfoliation glaucoma (PXFG: 4 [10%]); in controls included PACG 44 (55%) and POAG 36 (45%), (P < 0.001). Trabeculectomy was performed in 24 cases (50%) and 28 (35%) controls, phaco-trabeculectomy in 14 cases (35%) and 52 eyes (65%) in controls, and cataract surgery in 2 cases (5%) (P = 0.004). Factors associated on univariate analysis included PACG (odds ratio [OR]: 12.68, 95% confidence interval [CI]; 2.84, 56.62, P < 0.001, synechial angle closure > 180° (OR: 10.1, 95% CI: 2.87, 35.44, P < 0.001, higher preoperative IOP > 22 mmHg (OR: 5.32, 95% CI: 2.64, 10.73, P < 0.001), trabeculectomy (OR: 3.05, 95% CI: 1.36, 6.83, P = 0.007) and axial length < 22 mm (OR: 6.80, 95% CI: 2.51, 18.46, P < 0.001. The use of postoperative cycloplegics was protective on univariate analysis (OR: 0.268, 95% CI: 0.12, 0.596), P < 0.001). Preoperative IOP > 22 mmHg (2.85, 95% CI: 1.11, 7.31, P = 0.02), and trabeculectomy (OR: 4.09, 95% CI: 1.48, 11.3, P = 0.007) remained significant on multivariate analysis.
Conclusion: PACG eyes with higher preoperative IOP and eyes undergoing trabeculectomy surgery alone, increased the likelihood of developing MG.
期刊介绍:
Indian Journal of Ophthalmology covers clinical, experimental, basic science research and translational research studies related to medical, ethical and social issues in field of ophthalmology and vision science. Articles with clinical interest and implications will be given preference.