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Risk Factors for Delayed Suprachoroidal Hemorrhage Following Glaucoma Surgery
  1. V.Swetha E Jeganathan,
  2. Sudipta Ghosh (sudipta18{at}rediffmail.com),
  3. Jonathan B Ruddle,
  4. Viney Gupta,
  5. Michael A Coote,
  6. Jonathan G Crowston (crowston{at}unimelb.edu.au)
  1. Centre for Eye Research Australia, University of Melbourne, Australia
  2. Centre for Eye Research Australia, University of Melbourne, Australia
  3. Centre for Eye Research Australia, University of Melbourne, Australia
  4. Royal Victorian Eye and Ear Hospital, Australia
  5. Royal Victorian Eye and Ear Hospital, Australia
  6. Centre for Eye Research Australia, University of Melbourne, Australia

    Abstract

    Aim: To determine the incidence, risk factors for and outcomes of delayed suprachoroidal hemorrhage (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 to a matched-control population that underwent equivalent procedures but did not develop DSCH. The main outcomes 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 to trabeculectomy-associated DSCH (P<0.0001; Odds ratio=3.4; 95%Confidence Interval=1.9 to 5.4). Risk factors for DSCH included low postoperative intraocular pressure (≤3mmHg; 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 were poor (LogMAR 1.34 ± 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 to trabeculectomy. Caution should be exercised when operating on patients with known ocular and systemic risk factors.

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