title: Incidence and risk factors for traumatic intraocular pressure elevation and traumatic glaucoma after open-globe injury.
abstract: OBJECTIVE
  To examine traumatic intraocular pressure (IOP) elevation and glaucoma after open-globe injury.
  
  
  METHODS
  Retrospective, observational case series.
  
  
  METHODS
  Review of patients with open-globe repair at the University of Washington from May 1997 through July 2010. Traumatic IOP elevation and glaucoma were defined respectively as intraocular pressure (IOP) ≥22 mm Hg at >1 visit or need for glaucoma medication, and long-term (at least 3 months) glaucoma medication use or glaucoma surgery.
  
  
  RESULTS
  We included 515 eyes (515 patients). The mean follow-up was 12.6±20.1 months. One hundred twenty eyes (23.3%) developed traumatic IOP elevation, of which 32 (6.2%) developed glaucoma; six eyes (1.2%) required glaucoma surgery. The mean time to development of traumatic IOP elevation was 1.5±3.4 months (range 1 day to 2 years). Kaplan-Meier 6- and 12-month estimates for development of traumatic IOP elevation were 27.2 and 32.4%, respectively, and for development of traumatic glaucoma were 7.1 and 11.0%, respectively. Multivariate regression revealed associations between traumatic IOP elevation and older age, and traumatic glaucoma and prior penetrating keratoplasty, initial vitreous hemorrhage, Zone II injury, and penetrating keratoplasty after open-globe repair. Traumatic glaucoma was controlled (IOP <22 mm Hg) in 78.1% of eyes at final follow-up, with mean IOP of 18.2 mm Hg on 1.7 medications.
  
  
  CONCLUSIONS
  Traumatic IOP elevation and glaucoma were common after visually salvageable open-globe injury. Most cases developed within 6 months, although longer follow-up remains important for case detection. Penetrating keratoplasty before or after repair, and vitreous hemorrhage were notable risk factors.
authors.affiliation: Department of Ophthalmology, University of Washington, Seattle, WA, USA.
authors.forename: K D
authors.initials: KD
authors.lastname: Bojikian
authors.affiliation: Department of Ophthalmology, University of Washington, Seattle, WA, USA.
authors.forename: A L
authors.initials: AL
authors.lastname: Stein
authors.affiliation: Department of Ophthalmology, University of Washington, Seattle, WA, USA.
authors.forename: M A
authors.initials: MA
authors.lastname: Slabaugh
authors.affiliation: Department of Ophthalmology, University of Washington, Seattle, WA, USA.
authors.forename: P P
authors.initials: PP
authors.lastname: Chen
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000959:Antihypertensive Agents / Q000627:therapeutic use; D002648:Child; D015807:Eye Injuries, Penetrating / Q000150:complications*; D005260:Female; D018463:Filtering Surgery; D005500:Follow-Up Studies; D005901:Glaucoma / Q000453:epidemiology* / Q000209:etiology / Q000628:therapy; D006801:Humans; D015994:Incidence; D007429:Intraocular Pressure; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012307:Risk Factors; D014065:Tonometry, Ocular; D014792:Visual Acuity / Q000502:physiology
chemical_list: D000959:Antihypertensive Agents