Early Predictors of Traumatic Glaucoma After Closed Globe Injury

Abstract

Objective: To prospectively analyze the clinical and ul- trasonographic biomicroscopy (UBM) features in eyes with closed globe injury, at the initial examination, that would predict the occurrence of chronic traumatic glau- coma during a 6-month follow-up. Methods: Forty consecutive eyes with closed globe in- jury and a chronically elevated intraocular pressure (IOP) of at least 21 mm Hg for a minimum of 3 months were diagnosed as having traumatic glaucoma and compared with 52 eyes with closed globe injury and no evidence of glaucoma. Results: The median grade of trabecular pigmentation on gonioscopy in eyes with traumatic glaucoma was 3 compared with 2 in eyes without glaucoma (P=.001). On UBM findings, 18 eyes with closed globe injury without glaucoma showed evidence of cyclodialysis, compared with 7 eyes with glaucoma (P=.001). The relative risk of developing traumatic glaucoma was also significantly higher with hyphema, elevated baseline IOP, angle re- cession ofmore than 180°, lens displacement, and wider angles on UBM. Conclusions: Clinically, the presence of increased pig- mentation at the angle, elevated baseline IOP, hy- phema, lens displacement, and angle recession of more than 180° were significantly associated with the occur- rence of chronic glaucoma after closed globe injury. On UBM findings, a wider angle and the absence of cyclo- dialysis were significant predictors for the subsequent de- velopment of traumatic glaucoma.