Glaucoma after Lens-Sparing Vitrectomy for Advanced Retinopathy of Prematurity

Nudleman, Eric; Müftüoğlu, İlkay Kılıç; Gaber, Raouf; Robinson, Joshua; Drenser, Kimberly A.; Capone, Antonio; Trese, Michael T.

doi:10.1016/j.ophtha.2017.11.009

Cited by 20 publications

(17 citation statements)

References 22 publications

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“…Most frequently reported complication is that of glaucoma following surgery with incidence up to 33.3%. [37515455565758] In one of the recent reports, the risk of postoperative secondary glaucoma was higher in eyes that underwent lensectomy during the surgical procedure. [58]…”

Section: Complications Of Surgerymentioning

confidence: 99%

Stage 5 retinopathy of prematurity: An update

Sen

Jain

Bhende

2018

Taiwan J Ophthalmol

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Retinopathy of prematurity (ROP) is one of the most common causes of preventable blindness in children. In spite of the availability of various treatment options, and favorable results with timely intervention, many infants present to the ophthalmologists in the advanced end stage of the disease due to lack of awareness especially in the developing nations. This blinding or Stage 5 of ROP presents with total retinal detachment and has to be managed surgically. The surgical techniques for Stage 5 ROP are unique and demanding. The successful anatomical results after surgery are only seen in 20%–50% of cases. In spite of a successful anatomical result, the visual outcome may be slow and limited. The use of newer pharmacological adjuncts has shown promising results. Because of heterogeneity of presentation of the disease severity, a genetic predisposition has also been proposed. A concerted effort from the pediatricians, ophthalmologists, and healthcare workers is required to establish effective screening and treatment guidelines to prevent blindness due to ROP. Till then surgical management has to be done. Parents must be educated regarding the limited visual benefits of surgery and the need for prolonged follow-up. This review gives a comprehensive overview of the pathogenesis, clinical aspects, surgical interventions, and their outcomes and future prospects of Stage 5 ROP.

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Section: Complications Of Surgerymentioning

confidence: 99%

Stage 5 retinopathy of prematurity: An update

Sen

Jain

Bhende

2018

Taiwan J Ophthalmol

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“…Moreover, previous studies have relied upon IOP measurement as the sole criterion for diagnosing glaucoma. [56] We did not measure IOP in all our cases and the diagnosis of glaucoma was clinical, although all diagnosed cases of glaucoma had IOPs greater than 21 mmHg.…”

Section: Discussionmentioning

confidence: 99%

“…Secondary glaucoma has been described in advanced stages of ROP,[2] although development of secondary glaucoma with surgically treated ROP is not a common occurrence. [456]…”

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confidence: 99%

Short-term incidence and management of glaucoma after successful surgery for stage 4 retinopathy of prematurity

Chandra

Tewari

Salunkhe

et al. 2019

Indian J Ophthalmol

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Purpose: The purpose of this study is to describe the short-term incidence, clinical features, and management of glaucoma in children after successful surgery for stage 4 retinopathy of prematurity (ROP). Methods: The retrospective study included all eyes undergoing successful surgery for stage 4 ROP with good outcomes at a tertiary eye care center between June 2014 and June 2016. Cases developing postoperative glaucoma underwent examination under anesthesia for measurement of intraocular pressures (IOP), corneal diameters, Retcam-assisted fundus imaging, and gonioscopy. Outcomes of glaucoma management were evaluated. Results: Hundred eyes of 70 babies underwent successful surgery for stage 4 ROP (with postoperative attached retina, and minimal sequelae) with minimum follow-up of 15 months. Six eyes (6%) developed postoperative glaucoma. Of these, four eyes had undergone lens-sparing vitrectomy and two were managed with lensectomy and vitrectomy (LV). Median time duration for development of glaucoma after primary vitreous surgery was 17.5 weeks. Two cases could be managed with topical IOP-lowering agents alone, whereas four required filtering surgeries (trabeculotomy with trabeculectomy and 0.04% mitomycin C [MMC] application). Average IOP decreased from 25 ± 2.36 to 12.2 ± 2.05 mmHg at 12 months from glaucoma diagnosis. Conclusion: Glaucoma is a potential adverse event following successful vitreous surgery for stage 4 ROP. A combined trabeculotomy–trabeculectomy along with MMC gives favorable outcome.

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“…TO THE EDITOR: We read with enthusiasm the publication by Nudleman et al 1 As the authors recognized, glaucoma associated with retinopathy of prematurity is an increasingly important entity as the survival rate of preterm infants increases and the survivable gestational age decreases. We would like to share some comments in hopes of generating discussion and systematizing terminology.…”

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confidence: 99%

“…In the article by Nudleman et al, the authors used a strictly IOP-based criterion for the diagnosis of glaucoma, such that any child with IOP of 23 mmHg on 2 consecutive examinations under anesthesia was diagnosed with glaucoma. 1 This criterion makes intuitive sense but is incomplete. For example, if IOP-lowering therapy were initiated after the first episode of IOP elevation, then a child with glaucoma may fail to meet the criteria of requiring 2 consecutive examinations demonstrating elevated IOP.…”

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confidence: 99%