Incidence and Risk Factors for Intraocular Pressure Rise after the Scleral Buckle Surgery for Retinal Detachment

Purpose: To determine the incidence and risk factors for intraocular pressure (IOP) rise after the scleral buckle (SB) procedure for retinal detachment (RD). Methods: A retrospective chart review of the medical records of patients, who underwent RD repair by SB performed by a single surgeon and had a minimum follow-up of 6 months was carried out. The outcome measures were the incidence of IOP rise in the operated eyes and the associated risk factors. Results: Fifty-two eyes of 52 patients with a median postsurgical follow-up of 18 months (interquartile range: 6, 36, range: 6-60 months) were included. Seven eyes had encircling buckle, 23 eyes had encircling buckle and 1 quadrant segmental buckle, and 22 eyes had encircling buckle and 2 quadrant segmental buckle. IOP rise was seen in 15/52 eyes (28.85%), within 1 month of the SB surgery. Nine out of 15 eyes (60%) of patients <40 years of age had a rise in IOP as compared to 6/37 eyes (16.2%) of patients >40 years of age (P = 0.002). Patients <40 years had a significant increased risk of developing IOP rise, compared to those above 40 years of age (adjusted odds ratio: 7.246 with 95% confidence interval of 1.641-31.986, P = 0.009). None of the fellow eyes had a rise in IOP during the follow-up period. None of the operated eyes with raised IOP progressed to glaucoma. Conclusions: Elevated IOP is a common complication after the SB procedure, and age <40 years is associated with a greater risk of development of increase in the IOP. Hence, IOP monitoring after the SB surgery is of paramount importance to detect early rise during follow-up.