Treatment of glaucoma associated with retinopathy of prematurity in children

• Yulduz A. Khamroeva
• Lola S. Khamraeva

Abstract

Objective.To present the results of hypotensive glaucoma surgery in children with retinopathy of prematurity (ROP).

Material and methods. An analysis of surgical hypotensive treatment of glaucoma in 6 (9 eyes) children with ROP aged from 1 month to 1 year was carried out in the eye department of the clinic of the Tashkent Pediatric Medical Institute. According to the stages and phases of ROP, patients were divided into 2 groups, the first included 3 (5 eyes) children with stages I–III of the active phase of the disease, the second – 3 children (4 eyes) with stages IV–V regressive (scar) phase. One patient had a bilateral process with stage V regressive phase with postoperative aniridia. The gestational age at birth of the examined children was 21–36 weeks. The duration of observation is 18 months. Taking into account echobiometric and gonioscopic characteristics, the type and volume of hypotensive surgical treatment were determined. In the first group, ab externa sinusotrabeculotomy was performed, in the second group, ab externa sinusotrabeculotomy, cyclodialysis, cycloretraction with autoscleral drainage.

Results. Surgical antihypertensive treatment in stages I–III of the active phase of ROP led to stabilization of the glaucomatous process in 77% of cases; in stages IV–V of the scar phase, satisfactory results were noted in 50%. Moreover, hemorrhagic complications after 18 months led to subatrophy of the eyeball in 2 (50%) cases in patients in the second group of patients.

Conclusion. In the active phase of stages I–III of ROP, hypotensive surgery in the trabecular zone was used; in the cicatricial phase of stages IV–V of ROP, combined hypotensive surgery was used both in the trabecular zone and in the ciliary body area using autoscleral drainage.

Keywords: retinopathy of prematurity; glaucoma; antiglaucomatous surgery; gonioscopy; mesodermal tissue; lensvitreoshwartectomy; hyphema; hemophthalmos; subatrophy of the eyeball; aniridia

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