Silicone oil induced glaucoma: risk factors and management results
Les névrites optiques de l’enfant : particularités cliniques, thérapeutiques et facteurs pronostiques
24 avril 2022Systemic risk factors underlying primary open-angle glaucoma
24 avril 2022
Glaucome siliconique: facteurs de risque et résultats de la prise en charge.
Houda Lajmi*, Amin Zahaf, El Ouafi Bouazzaoui, Anis Bekir, Wassim Hmaied.
Department of Ophthalmology, FSI Hospital, La Marsa, Tunisia
Faculty of Medicine, University of Tunis El Manar, Tunis, Tunisia
Keywords
Retinal detachment, Silicone oil, Glaucoma, Risk factors, Therapeutics.
Abstract
Purpose. Our aim was to describe the risk factors of silicone oil induced glaucoma (SOIG), to discuss the challenges encountered during management as well as its results.
Methods. Retrospective study including 120 eyes operated by 23 gauges pars plana vitrectomy with silicone oil (SO) tamponade. All patients had a complete pre- and post-operative assessment. SOIG was defined as a postoperative intra ocu- lar pressure (IOP) greater than 21mmHg for at least 6 weeks. Patients who developed intra ocular hypertension (IOHT) underwent SO removal and were put on medical, laser or surgical treatment if OHT persisted. We studied the risk factors SOIG onset as and IOP control rates with each therapeutical means.
Results. SOIG was noted in 45 patients (37,5%). The risk factors found in the univariate study were diabetes (p=0,007), rhegmatogenous retinal detachment (p=0,036), SO presence in the anterior chamber (AC) (p<0,001) and tamponade duration ≥ 12 months (p<0,001). In the multivariate study retained only tamponade duration ≥ 12 months (OR=13,03). SO was removed after 14,53 ± 8.87 months on average. IOP control was achieved with SO removal in 6 cases (13,33%), medical treatment in 30 cases (77%), selective laser trabeculoplasty (SLT) treatment in 6 cases (13,33%), trabeculectomy in 2 cases (4,44%) and cyclodiode therapy in one case.
Conclusions. SOIG is a complication of SO injection that can affect the visual prognosis. Its management is difficult and could requires medical, laser or surgical treatment. Tamponade duration appears to be an important risk factor for SOIG occurrence.