Retinal Detachment After Primary Congenital Glaucoma Surgery.

Purpose: To report on retinal detachment (RD) in eyes that had surgery for primary congenital glaucoma (PCG).

Methods: This retrospective chart review took place at Alexandra Main University Hospital. The charts of 363 children (507eyes) presenting with and having surgery for PCG from January 2019 to March 2005 were reviewed. Eyes that developed RD were enrolled as cases and the remaining eyes as controls. Retrieved data included demographic and clinical characteristics and operative and postoperative follow-up data pertaining to glaucoma (and RD) surgery.

Results: The records revealed that 17 eyes of 13 children (cases) developed RD (bilateral in 4 children, 30.7%) (3.35% of eyes, 3.58% of children, rhegmatogenous in 15 eyes, 88.2%). The mean ± standard deviation of age at presentation of cases and controls wase 4.3 ± 3.8 and 8.1 ± 11.1 months, respectively (P = .22). There were no statistically significant differences in intraocular pressure (P = .76), corneal diameter (P = .22), axial length (P = .98), and cup/disk ratio (P = .45) between case and control eyes at glaucoma presentation. Case eyes had undergone twice as many glaucoma procedures as control eyes. At RD diagnosis, 5 eyes (29.4 %) had their glaucoma controlled and 8 eyes (47.1%) had inoperable RD. Four eyes underwent conventional retinopexy and 4 eyes underwent pars plana vitrectomy with silicone oil. The mean ± standard deviation of follow-up of case eyes was 63.7 ± 56.9 months before RD diagnosis and 45.9 ± 22.3 months after RD repair. There was a statistically significant difference in axial length at presentation and at the diagnosis of RD (P < .001) in case eyes. At the final follow-up visit, 7 eyes (41.2%) had atrophia.

Conclusions: RD occurred in 3.5% of eyes with PCG that had surgery over 14 years, of which 41% culminated in atrophia bulbi.