Glaucoma after ocular chemical burns: Incidence, risk factors, and outcome

Abstract

Effects of chemical injuries on the cornea and limbus have been widely studied; however, little is known about glaucoma after ocular chemical injuries. We herein investigated the incidence, risk factors, and outcome of glaucoma in patients with ocular chemical burns. Medical records were reviewed of patients who visited our clinic for chemical injuries to the ocular surface. Patients were divided into glaucoma and non-glaucoma groups based on high intraocular pressure (IOP) readings. Clinical characteristics, treatment method, and therapeutic and visual outcomes were compared between the two groups. Of 29 patients (40 eyes), 9 patients (15 eyes, 37.5%) were diagnosed with glaucoma at 2.64 +/- 2.92 months after injury. Factors associated with glaucoma included male gender (p=0.0114), bilateral ocular involvement (p=0.0478), severe ocular surface involvement (Dua grades IV-VI, p=0.0180), poor initial visual acuity (p=0.0136), high initial IOP (p<0.0001), pupil involvement at initial examination (p=0.0051), and the need for amniotic membrane transplantation in the acute stage (p=0.0079). At final follow-up, IOP was uncontrolled in 3 eyes (20.0%), and visual acuity was worse in the glaucoma group than in the non-glaucoma group (logMAR 2.94<plus/minus>1.86 vs 0.34 +/- 0.69, p<0.0001). These findings suggest that careful evaluation and intensive treatment for glaucoma are essential in patients with severe ocular burns.