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Published on: February 12, 2018
Delayed suprachoroidal hemorrhage after pediatric glaucoma surgery
Faisal E Ghadhfan1, Arif O Khan
1Division of Pediatric Ophthalmology, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia.
Insights
Delayed suprachoroidal hemorrhage is rare after pediatric glaucoma surgery. Ahmed valve implantation, especially in aphakic eyes, presents the highest risk for this complication.
Area of Science:
- Ophthalmology
- Pediatric Surgery
Background:
- Delayed suprachoroidal hemorrhage is a rare but serious complication following glaucoma surgery.
- Identifying risk factors is crucial for preventing this adverse event in pediatric patients.
Purpose of the Study:
- To identify surgical risk factors associated with delayed suprachoroidal hemorrhage after glaucoma surgery in children.
Main Methods:
- A retrospective literature review was conducted from 1966 to 2008.
- Pediatric glaucoma surgery outcomes were analyzed, focusing on cases of delayed suprachoroidal hemorrhage.
Main Results:
- Nine cases of delayed suprachoroidal hemorrhage were identified from 2,491 surgeries (0.36%).
- The complication occurred in 1.5% of Ahmed valve implantations (6/389), particularly in aphakic eyes.
- Three cases (0.4%) occurred after trabeculectomy with antimetabolites in aphakic eyes.
Conclusions:
- Delayed suprachoroidal hemorrhage is infrequent in pediatric glaucoma surgery.
- Ahmed valve implantation in aphakic eyes appears to carry the highest risk.
- Intraoperative mitomycin-C use may increase risk after Ahmed valve implantation and should be used cautiously.
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.
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