Clinical and echographical evaluation of early-onset choroidal detachment post-trabeculectomy [Evaluación clínica y ecográfica del desprendimiento coroideo de inicio temprano post-trabeculectomía]

Purpose: To evaluate the peri-operative, clinical and echographic differences in eyes that developed early choroidal detachment (CD) compared with those that did not had such complication after trabeculectomy. Methods: A cohort of 53 patients affected by uncontrolled glaucoma who underwent primary trabeculectomy was prospectively evaluated. A- and B-scan ultrasonography and a clinical examination were carried out 24 hours before and after surgery. Pre- and post-operative IOP, proportion of IOP reduction, blood pressure, type and number of glaucoma medicines, and surgeon's level of experience were collected variables. Results: From 53 operated eyes, the presence of CD was detected by echographic and/or clinical examination in 15 eyes (28.3%). Mean pre-operative IOP in eyes that developed CD (26.0 ± 8.0 mmHg) was significantly higher (P = 0.011) than in eyes not affected by this condition (21.2 ± 5.3 mmHg). One day after surgery, there was no significant difference (P = 0.390) in the post-operative IOP (5.0 ± 4.6 mmHg vs. 6.0 ± 5.6 mmHg). A proportion of eyes with a net reduction equal or greater than 15 mmHg was significantly higher in the CD group (P = 0.017). Conclusions: Our data supports the fact that early-onset CD after trabeculectomy appears to be more frequent in cases with higher pre-operative IOP and greater proportions of IOP reduction but not necessarily with lower post-operative IOP