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

To determine the incidence and risk factors for intraocular pressure (IOP) rise after the scleral buckle (SB) procedure for retinal detachment (RD).

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.

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.

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.