|Title||Management of Pediatric Aphakic Glaucoma With Vitrectomy and Tube Shunts.|
|Publication Type||Journal Article|
|Year of Publication||2016|
|Authors||Elshatory, Yasser M., Gauger Elizabeth H., Kwon Young H., Alward Wallace L. M., H Boldt Culver, Russell Stephen R., and Mahajan Vinit B.|
|Journal||J Pediatr Ophthalmol Strabismus|
|Date Published||2016 Nov 01|
|Keywords||Adolescent, Aphakia, Postcataract, Cataract, Cataract Extraction, Child, Child, Preschool, Female, Glaucoma, Glaucoma Drainage Implants, Humans, Infant, Intraocular Pressure, Male, Retrospective Studies, Visual Acuity, Vitrectomy|
PURPOSE: To review the impact of vitrectomy and tube shunts on mean intraocular pressure (IOP) and number of glaucoma medications in pediatric aphakic glaucoma.
METHODS: A retrospective review of pediatric patients who underwent combined vitrectomy and glaucoma tube shunt surgery for aphakic glaucoma was conducted. Inclusion criteria were: age 18 years or younger, diagnosis of aphakic glaucoma, preoperative IOP data, and postoperative IOP data for at least 6 months. Mean IOP lowering at 1 year, number of glaucoma medications at 1 year, and surgical complications, including tube occlusion in the postoperative period, were noted.
RESULTS: The mean ± standard deviation preoperative IOP was 33.9 ± 10.6 mm Hg (range: 18 to 57 mm Hg) with a mean of three topical IOP-lowering medications. A total of 5 (36%) Ahmed and 9 (64%) Baerveldt tube shunts were placed. One of the Baerveldt tube shunt procedures was combined with revision of a traumatically dislocated tube. The mean IOP at 12 months postoperatively was 16.6 ± 5.8 mm Hg (range: 6 to 28 mm Hg; P < .01, t = 3.74, df = 13) with a mean of 2.3 glaucoma medications. There were no cases of tube occlusion, corneal decompensation, endophthalmitis, or retinal detachment over the 12 months of follow-up.
CONCLUSIONS: Combined vitrectomy and placement of a glaucoma tube shunt can be safe and effective in lowering IOP based on mean IOP values and number of glaucoma medications at 1 year. [J Pediatr Ophthalmol Strabismus. 2016;53(6):339-343.].
|Alternate Journal||J Pediatr Ophthalmol Strabismus|