title: Retinal complications after aqueous shunt surgical procedures for glaucoma.
abstract: OBJECTIVE
  To assess retinal complications and to identify risk factors for retinal complications following aqueous shunt procedures.
  
  
  METHODS
  Records of 38 consecutive aqueous shunt procedures that were performed on 36 patients at the Eye Institute of the Medical College of Wisconsin, Milwaukee, from June 1993 to March 1995 (minimum follow-up, 6 months) were reviewed. The mean +/- SD follow-up was 11.4 +/- 5.2 months (median, 10.5 months).
  
  
  RESULTS
  Twelve patients (32%) had the following retinal complications: 4 serous choroidal effusions (10%) that required drainage, 3 suprachoroidal hemorrhages (8%), 2 vitreous hemorrhages (5%), 1 rhegmatogenous retinal detachment (3%), 1 endophthalmitis (3%), and 1 scleral buckling extrusion (3%). Surgical procedures for retinal complications were required in 8 (67%) of these 12 patients. Visual acuity decreased 2 lines or more in 9 (75%) of these 12 patients. The median onset of a postoperative retinal complication was 12.5 days, with 10 patients (83%) experiencing complications within 35 days. Serous choroidal effusions developed in 10 other patients (26%), and these effusions resolved spontaneously. Visual acuity decreased 2 lines or more in 2 (20%) of these additional 10 patients. Patients who experienced serious retinal complications were significantly older, had a higher rate of hypertension, and postoperative ocular hypotony. Serious retinal complications were distributed evenly among patients with Krupin valves with discs and Molteno and Baerveldt devices. Experience with the Ahmed glaucoma valve implant was limited.
  
  
  CONCLUSIONS
  Aqueous shunt procedures may be associated with significant retinal complications and subsequent visual loss.
authors.affiliation: Department of Ophthalmology, Medical College of Wisconsin, Milwaukee, USA.
authors.forename: S K
authors.initials: SK
authors.lastname: Law
authors.forename: J W
authors.initials: JW
authors.lastname: Kalenak
authors.forename: T B
authors.initials: TB
authors.lastname: Connor
authors.forename: J S
authors.initials: JS
authors.lastname: Pulido
authors.forename: D P
authors.initials: DP
authors.lastname: Han
authors.forename: W F
authors.initials: WF
authors.lastname: Mieler
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001082:Aqueous Humor / Q000378:metabolism*; D004322:Drainage; D005260:Female; D005901:Glaucoma / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D018465:Molteno Implants / Q000009:adverse effects; D011183:Postoperative Complications / Q000209:etiology*; D019736:Prostheses and Implants / Q000009:adverse effects*; D012164:Retinal Diseases / Q000209:etiology*; D012189:Retrospective Studies; D012307:Risk Factors; D014792:Visual Acuity