Risk factors for delayed suprachoroidal haemorrhage following glaucoma surgery
- 1Centre for Eye Research Australia, University of Melbourne, Victoria, Australia
- 2Singapore Eye Research Institute, Singapore National Eye Centre, Singapore
- 3Royal Victorian Eye and Ear Hospital, Victoria, Australia
- Professor J G Crowston, Glaucoma Investigative Research Unit, Centre for Eye Research Australia, 32, Gisborne Street, East Melbourne, VIC 3002, Australia;
- Accepted 20 July 2008
- Published Online First 6 August 2008
Aim: To determine the incidence, risk factors and outcomes of delayed suprachoroidal haemorrhage (DSCH) after glaucoma surgery.
Methods: A retrospective case-control study was performed at a tertiary referral eye hospital on patients who presented with DSCH following glaucoma surgery. Cases were compared with a matched-control population that underwent equivalent procedures but did not develop DSCH. The main outcome parameters were incidence of DSCH, risk factors associated with its occurrence, visual outcome and prognostic factors.
Results: Of the 2752 glaucoma surgeries performed during the 10-year recruitment period, 29 cases of DSCH (1%) were identified. An increased incidence of DSCH was observed after glaucoma drainage device implantation compared with trabeculectomy-associated DSCH (p<0.0001; odds ratio 3.4; 95% CI 1.9 to 5.4). Risk factors for DSCH included low postoperative intraocular pressure (⩽3 mm Hg; p<0.001), aphakia (p<0.001), prior intraocular surgery (p<0.002), hypertension (p<0.001), anticoagulation (p = 0.002), ischaemic heart disease (p = 0.001) and respiratory disease (p = 0.008). The visual outcome of patients with haemorrhage was poor (logMAR 1.34 (SD 0.41)) and was significantly worse when compared with the control group (p = 0.002).
Conclusions: In this study cohort, DSCH occurred more frequently after glaucoma drainage device implantation compared with trabeculectomy. Caution should be exercised when operating on patients with known ocular and systemic risk factors.
Competing interests: None.
Ethics approval: Ethics approval was obtained from the Royal Victorian Eye and Ear Hospital.