Assessing the need for posterior sclerotomy at the time of filtering surgery in patients with Sturge-Weber syndrome☆
Presented in part as a poster at the annual meeting of the American Academy of Ophthalmology, Dallas, Texas, October 2000, and at the annual meeting of the Association for Research in Vision and Ophthalmology, Fort Lauderdale, Florida, 1998.
Received 11 July 2002; accepted 24 December 2002.
Abstract
Purpose
Posterior sclerotomy has been recommended for prevention of intraoperative choroidal hemorrhages and choroidal effusions in patients with Sturge-Weber syndrome (SWS) or Klippel-Trenaunay-Weber (KTW) syndrome undergoing glaucoma filtering surgery. In this study, we evaluated this unproven clinical perception.
Design
A retrospective, noncomparative, case series.
Participants
Seventeen consecutive patients with SWS or KTW syndrome who underwent glaucoma filtering surgery without prophylactic posterior sclerotomy or other prophylactic measures between January 1973 and March 1997 at a university-based practice.
Intervention
Glaucoma filtering surgery without prophylactic posterior sclerotomy.
Main outcome measures
Incidence of intraoperative and postoperative choroidal effusion, choroidal detachment, or choroidal hemorrhage.
Results
No intraoperative choroidal effusion, choroidal detachment, or choroidal hemorrhage occurred in this series. After surgery, 6 patients had a transient choroidal effusion. Surgical drainage was not required in any of them. No suprachoroidal hemorrhages occurred after surgery.
Conclusions
We did not encounter significant intraoperative suprachoroidal hemorrhage, choroidal effusions, or a combination requiring therapeutic intervention in our series. This finding leads us to question the necessity for prophylactic posterior sclerotomy to prevent the occurrence of these complications in patients with SWS and KTW syndrome undergoing glaucoma filtering surgery.
1Department of Ophthalmology and Visual Sciences, Kellogg Eye Center, Ann Arbor, Michigan, USA
2Department of Epidemiology, University of Michigan, Ann Arbor, Michigan, USA
Correspondence to Maya Eibschitz, MD, 1000 Wall Street, Ann Arbor, MI 48105, USA.
ABSTRACT