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Glaucoma after Lens-Sparing Vitrectomy for Advanced Retinopathy of Prematurity
Eric Nudleman1, Ilkay Kilic Muftuoglu2, Raouf Gaber3
1Department of Ophthalmology, Shiley Eye Institute, University of California San Diego, San Diego, California; Associated Retinal Consultants, Oakland University William Beaumont School of Medicine, Royal Oak, Michigan.
Ophthalmology
|December 16, 2017
Summary
Glaucoma developed in 10% of eyes after lens-sparing vitrectomy for advanced retinopathy of prematurity. Lensectomy significantly increased the risk of glaucoma, especially in more severe ROP cases.
Area of Science:
- Ophthalmology
- Pediatric Surgery
- Retinopathy of Prematurity
Background:
- Advanced retinopathy of prematurity (ROP) poses significant challenges in pediatric eye care.
- Lens-sparing vitrectomy (LSV) is a critical surgical intervention for severe ROP.
- Glaucoma is a potential sight-threatening complication following ROP treatment.
Purpose of the Study:
- To determine the incidence of glaucoma after LSV in advanced ROP.
- To identify factors associated with the development of glaucoma post-LSV.
Main Methods:
- Retrospective case series of 401 eyes from 270 patients with stage 4A, 4B, and 5 ROP.
- Analysis of medical records for glaucoma development, time to glaucoma, and associated factors.
- Lensectomy was analyzed as a time-dependent covariate.
Main Results:
- Glaucoma occurred in 10.0% of eyes (40/401) over a mean follow-up of 3.06 years.
- Incidence varied by ROP stage: 6.9% (stage 4A), 12.0% (stage 4B), and 33.3% (stage 5).
- Lensectomy (21% of eyes) was independently associated with an increased hazard of glaucoma (HR=2.76, P=0.004).
Conclusions:
- More severe ROP stages are linked to a higher glaucoma incidence post-LSV.
- Lensectomy, often due to ROP progression or lens opacity, significantly elevates the risk of developing glaucoma.
- Close monitoring for glaucoma is crucial in ROP patients undergoing LSV, particularly those requiring lensectomy.
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