ANNULAR PERIPHERAL CHOROIDAL DETACHMENT SIMULATING AQUEOUS MISDIRECTION AFTER GLAUCOMA SURGERY

Purpose: The purpose of the study was to define a newly recognized com plication after glaucoma surgery and to recommend a therapeutic regime n. Methods: Eighteen patients diagnosed initially as having aqueous mi sdirection after glaucoma surgery, but who subsequently were found by ultrasonography to have an annular peripheral choroidal detachment tha t resulted in secondary angle closure glaucoma, were studied. Ten of t hese patients were treated with topical cycloplegics and corticosteroi ds, and 8 were treated with drainage of suprachoroidal fluid. Outcomes of these two treatment methods were compared. Results: Annular periph eral choroidal detachment reliably was diagnosed with ultrasonography. Of the variables studied, time elapsed before resolution of the annul ar peripheral choroidal detachment was noted to be statistically signi ficant (P < 0.00005). Immediate resolution followed drainage of suprac horoidal fluid, whereas a mean of 19.6 days was required for resolutio n after medical therapy. Conclusions: Annular peripheral choroidal det achment should be considered in the differential diagnosis of a flat o r shallow anterior chamber with normal or high intraocular pressure af ter glaucoma surgery. The diagnosis of annular peripheral choroidal de tachment can be confirmed most reliably by ultrasonography. Medical th erapy is as effective as is surgery, although a significantly longer t ime to resolution is required.