Prognostic value of anterior chamber hemorrhage after glaucoma filtering surgery

Purpose Evaluation of the prognostic significance of a postoperative anteri or chamber hemorrhage (ACH) after glaucoma filtering surgery. Patients and Methods Records of 332 patients, who had undergone filtering s urgery between 1/1993 and 2/1997, were analyzed retrospectively with partic ular concern on epidemiologic data, pre- and postoperative regulation of in traocular pressure (IOP), complications including AGH, post operative 5-flu ouracil (5-FU) therapy and postoperative IOP lowering therapy. Surgical suc cess was defined as (1) IOP reduction below 21 mm Hg, (2) relative IOP redu ction at least 20% and (3) no reoperation to control IOP until the first-ye ar examination. Results 60 out of 332 patients (18.1%) suffered from ACH after glaucoma fil tering surgery, 24 patients with ACM were treated with 5-FU, postoperativel y. When all patients with ACH were considered in the evaluation, the differ ence between the success rate of patients with ACI-I and the success rate o f patients without ACH was not statistically significant. In contrast, when ACI-I was the only complication in patients, who were not treated with 5-F U, the success rate was significantly worse (38%), when compared with the c ontrol group (patients, who did not have ACH or who had other complications in addition to ACH) (67%) (p=0.008). When patients with these criteria rec eived 5-FU postoperatively, the difference between success rates of both gr oups was not any longer statistically significant (p=0.99). Discussion The postoperative occurrence of anterior chamber hemorrhage is a ssociated with a higher failure rate of filtering surgery. Early administra tion of 5-FU is recommended in these cases.