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Risk factors and outcomes of management of delayed suprachoroidal haemorrhage following Ahmed glaucoma valve implantation in children
  1. Shantha Balekudaru1,
  2. Tamonash Basu2,
  3. Parveen Sen3,
  4. Pramod Bhende4,
  5. Vijaya Lingam1,
  6. Ronnie George1
  1. 1Smt Jadhavabhai Nathmal Singhvee Glaucoma Services, Medical Research Foundation, Sankara Nethralaya, Chennai, India
  2. 2Glaucoma, Medical Research Foundation, Sankara Nethralaya, Kolkata, India
  3. 3Shri Bhagwan Mahavir Vitreoretinal Services, Medical Research Foundation, Sankara Nethralaya, Chennai, India
  4. 4Shri Bhagwan Mahavir Vitreoretinal Services, Medical Research Foundation, Chennai, India
  1. Correspondence to Dr Shantha Balekudaru, Smt Jadhavabhai Nathmal Singhvee Glaucoma Services, Medical Research Foundation, Sankara Nethralaya, Chennai 600006, Tamil Nadu, India; shantha.acharya{at}gmail.com

Abstract

Aims To assess the incidence, risk factors and outcomes of management of delayed suprachoroidal haemorrhage (DSCH) in children who had undergone Ahmed glaucoma valve implantation.

Methods A retrospective case-control study of eyes which developed DSCH in children <18 years of age who underwent surgery between January 2009 and December 2017 with a follow-up of at least 2 months was performed. Nine cases were compared with 27 age, gender and surgeon matched controls who had undergone surgery during this period.

Results The incidence of DSCH was 4.7% (95% CL 1.5% to 7.7%, 9 eyes of 191 children). There were no significant differences between cases and controls in baseline details except for the number of intraocular pressure (IOP) lowering medications (p=0.01) and follow-up period (p=0.001). Risk factors identified on univariate analysis (p≤0.1) were axial length (p=0.02), diagnosis of primary congenital glaucoma (p=0.05), postoperative hypotony (p=0.07) and aphakia (p=0.1). None of them were found to be significant on multivariate analysis. Five eyes, three with retinal apposition and two with retinal detachment, underwent surgical drainage. There were no significant differences in the outcomes of eyes which underwent drainage compared with those which did not. Failures, defined as IOP>18 mm Hg despite use of medications, loss of light perception, phthisis or removal of the implant were more frequent in cases (three eyes, 33.3%) compared with controls (four eyes, 14.8%) (p=0.002).

Conclusions None of the risk factors analysed in our series proved to be significant. Failures were more common in eyes with choroidal haemorrhage, despite surgical intervention.

  • glaucoma
  • treatment surgery
  • choroid
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Footnotes

  • Contributors TB: data collection, PS: contributed to surgical management of the choroidal haemorrhage and reviewed manuscript, PB: contributed to surgical management of the choroidal haemorrhage and reviewed manuscript, VL and RG: contributed to the data used and reviewed manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Ethics approval Institutional Review Board (Ethics Committee) of Vision Research Foundation, Sankara Nethralaya, Chennai, India. Approval Number: 742-2018-P, dt. 20.12.2018.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement All data relevant to the study are included in the article or uploaded as supplementary information.

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