BIẾN CHỨNG CỦA PHẪU THUẬT CẮT BÈ CỦNG GIÁC MẠC TRONG ĐIỀU TRỊ GLÔCÔM GÓC ĐÓNG CƠN CẤP KHÔNG CẮT CƠN KHÔNG KÈM THEO ĐỤC THỂ THỦY TINH

Abstract

Objectives: To evaluate the complications of trabeculectomy for unresponsive acute PACG without cataract. Patients and Methods: 31 eligible eyes were recruited into the study from 3 centers Vietnam National Eye Hospital, Ha Dong Eye Hospital and Eye department of 103 Military Hospital from January 2018 to November 2019. Results: All of 31 eyes achieved good results with 100% IOP control after 1 year of follow-up. However, there was a certain number of complications occurred. Intraoperatively, the rate of complications was 29.03% including hyphema (25.81%), vitreous hemorrhage (3.22%), two third of which were managed successfully during the surgery (66.67%) and the remaining one third by medical treatment after surgery (33.33%). Post operation, the complication rate was 74.19%, including choroidal detachment 12.9%, bleb leaking 12.9%, flattened bleb 19.35%, anterior uveitis 22.58%, cataract 6,44%; Most of them self-limited rapidly after 2 weeks (except cataract) (from 67.74% to 19.35%). Preoperative very high intraocular pressure (IOP) possibly increased the rate of hyphema and choroidal detachment (<0.001, Chi square test), prolonged attack duration might increase the rate of choroidal detachment (<0.001, Chi square test), uveitis (0.03, Chi square test). Complications are mostly well controlled with medical treatments, and do not affect surgical results after 12 months. Conclusion: Trabeculectomy is still a significant surgery in controlling IOP in the treatment of acute angle-closure glaucoma (ACAG) without cataracts, however, the high rate of complications should be followed. detected and treated timely.