The broad objective of this research proposal is to decrease the morbidity of glaucoma surgery. This objective will be accomplished by achieving the specific aim of determining the risk factors for endophthalmitis, suprachoroidal hemorrhage, hypotony and severe vision loss following filtration surgery, drainage device surgery, and cyclodestructive procedures. Data will be collected prospectively for 4 years from 200 ophthalmologists performing a total of 20,000 operations a year. The medical records of those eyes identified with surgical complications will be reviewed along with matched controls for each case. Information will be abstracted from each chart concerning race, age, gender, use of antifibrosis agents, refractive error, lens status, type of surgery, additional surgery or procedures, post-operative ocular medications, presence of bleb leak or blepharitis, and systemic diseases. The data will be analyzed utilizing univariate, bi-variate, and conditional logistic regression analysis. From this information we will determine the risk factors for the serious complications of surgery. Furthermore, we will collect information on the outcomes of these complications in terms of visual acuity, visual field, and intraocular pressure, and correlate the outcome with patient and ocular characteristics as well as treatment. The results of the study may allow physicians to reduce the morbidity of glaucoma surgery by altering their indications for surgery, surgical technique, and postoperative follow-up.
