Faisal E Ghadhfan1, Arif O Khan. 1. Division of Pediatric Ophthalmology, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia.
Abstract
INTRODUCTION: The purpose of this study was to identify surgical risk factors for delayed suprachoroidal hemorrhage after glaucoma surgery in children. METHODS: A retrospective literature review (1966-2008) of pediatric glaucoma surgery outcomes (performed in patients <18 years of age) was conducted; cases of delayed suprachoroidal hemorrhage were identified and reviewed. RESULTS: The literature review identified 2,491 surgeries, from which 9 cases of delayed suprachoroidal hemorrhage (9/2,491, 0.36%) were documented in 5 case series. Six (4 documented aphakic, 2 possibly aphakic) occurred after Ahmed valve implantation (6/389, 1.5%; 2 of the 6 cases associated with intraoperative mitomycin-C use). The other 3 (all 3 possibly aphakic) occurred after trabeculectomy with antimetabolite (3/741, 0.4%). CONCLUSIONS: There are few reports of pediatric delayed suprachoroidal hemorrhage. The greatest risk for this complication seems to be after Ahmed valve implantation in the setting of aphakia. Because intraoperative mitomycin-C use may increase the risk for pediatric delayed suprachoroidal hemorrhage after Ahmed valve implantation, mitomycin-C should not be applied in this setting without evidence for improved valve function from its use.
INTRODUCTION: The purpose of this study was to identify surgical risk factors for delayed suprachoroidal hemorrhage after glaucoma surgery in children. METHODS: A retrospective literature review (1966-2008) of pediatric glaucoma surgery outcomes (performed in patients <18 years of age) was conducted; cases of delayed suprachoroidal hemorrhage were identified and reviewed. RESULTS: The literature review identified 2,491 surgeries, from which 9 cases of delayed suprachoroidal hemorrhage (9/2,491, 0.36%) were documented in 5 case series. Six (4 documented aphakic, 2 possibly aphakic) occurred after Ahmed valve implantation (6/389, 1.5%; 2 of the 6 cases associated with intraoperative mitomycin-C use). The other 3 (all 3 possibly aphakic) occurred after trabeculectomy with antimetabolite (3/741, 0.4%). CONCLUSIONS: There are few reports of pediatric delayed suprachoroidal hemorrhage. The greatest risk for this complication seems to be after Ahmed valve implantation in the setting of aphakia. Because intraoperative mitomycin-C use may increase the risk for pediatric delayed suprachoroidal hemorrhage after Ahmed valve implantation, mitomycin-C should not be applied in this setting without evidence for improved valve function from its use.
Authors: Kamyar Vaziri; Stephen G Schwartz; Krishna S Kishor; Jorge A Fortun; Darius M Moshfeghi; Andrew A Moshfeghi; Harry W Flynn Journal: Clin Ophthalmol Date: 2015-04-02