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Lens-sparing vitrectomy associated with greater glaucoma risk in ROP
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A higher incidence of glaucoma was associated with lens-sparing vitrectomy in patients with more severe retinopathy of prematurity, according to a study.
A retrospective case series examined the medical records of 270 patients with advanced retinopathy of prematurity (ROP) who underwent lens-sparing vitrectomy. The study included a total of 401 eyes in stage 4A, 4B and 5 ROP.
Glaucoma was identified in 40 eyes (10%) during the follow-up period (mean 3.06 years), with greater incidence correlated with greater severity of ROP.
Patients with stage 4A ROP had a 6.9% (17 of 247) incidence of glaucoma, while those with stage 4B had a 12% (16 of 133) incidence. Incidence in patients with stage 5 ROP was 33.3% (7 of 21).
Lensectomy was performed following lens-sparing vitrectomy in 22 of 40 eyes (55%) with glaucoma compared with 66 of 361 (18.2%) of eyes without glaucoma, a statistically significant difference (P < .001).
“Although hazard of time to glaucoma increased by 6.76 in eyes with stage 5 ROP compared with those with stage 4A disease, lensectomy was the most significant independent factor for time to glaucoma, indicating that patients undergoing lensectomy were 2.76 times more likely to develop glaucoma than those without lensectomy,” the study authors said.
According to these results, children who require lensectomy should be closely monitored for long-term complications, the authors added. – by Rebecca L. Forand
Disclosure: The authors report no relevant financial disclosures.
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