Related factors of choroidal detachment after glaucoma filtering surgery and the preventive measures

Objective To investigate the related factors and the preventive measures of choroidal detachment after glaucoma filtering surgery. Methods The clinical data of 8 patients (10 eyes) with choroidal detachment out of 337 patients (378 eyes) undergoing glaucoma filtering surgery were analyzed retrospectively. Results Of the 8 patients (10 eyes) with choroidal detachment, acute angle closure glaucoma was found in 3 patients (3 eyes), chronic angle closure glaucoma in 4 patients (6 eyes), and neovascular glaucoma in 1 patient (1 eye). The youngest was 51 years old and the oldest was 73 years old with an average age of (65.25±5.58) years old. Of the 8 patients, primary hypertension was found in 1 patient, type Ⅱ diabetes in 4 patients (diabetes patients combined with hypertension in 3 out of the 4 patients). Intraocular pressure of 3 patients (4 eyes) was regulated to the normal level [(22.38-24.38) mmHg] by medicine before operation. The remaining 5 patients (6 eyes) underwent operation at high intraocular pressure [(35.76-50.10) mmHg]. Choroidal detachment occurred at 1-11 d, (5.25±2.2) d in average. Shallow anterior chambers of 6 eyes treated by medicine therapy recovered within 5-10 d, (7.5±1.04) d in average. Shallow anterior chamber of 4 eyes treated by surgery recovered within 1-6 d, (3.65±1.45) d in average. Conclusion Occurrence of the choroidal detachment after glaucoma filtering surgery is associated with many factors, such as high intraocular pressure before operation, diabetes, hypertension, and arteriosclerosis. The preventive measures of choroidal detachment after glaucoma filtering surgery include: controlling intraocular pressure as low as possible before operation, avoiding sudden reduced intraoculer pressure during operation, forming anterior chamber at the end of operation, using releasable scleral flap sutures, adopting corticosteroid and ciliary muscle anaesthetics after operation, and avoiding mental stress.