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Abstract #46078 Published in IGR 13-2
Encapsulation of glaucoma tube shunt devices in sturge- Weber syndrome and other pediatric glaucomas
Khitri MR; Mills M; Ying G-S; Davidson S; Quinn GJournal of AAPOS 2011; 15: 22
Introduction: The subconjunctival bleb is critical to the success of glaucoma tube shunt devices and maintaining aqueous outflow. Patients with Sturge-Weber syndrome (SWS) and glaucoma have abnormal subconjunctival tissues with increased vascularity, which may affect bleb function. This study aimed to compare the relative rates of tube shunt device failures from encapsulation (bleb failure) in children with glaucoma related to SWS and other glaucoma types. Methods: A retrospective chart review was undertaken of all children having undergone tube shunt implantation for glaucoma at the Children's Hospital of Philadelphia from 2000-2010. Eyes with tube shunt failure were classified by the etiology of tube failure and glaucoma diagnosis. Results: Records of 57 eyes of 46 patients were reviewed. The glaucoma diagnoses in this group were as follows: 18 aphakic, 12 SWS, 12 congenital, 4 uveitis, 4 Axenfeld anomaly, 3 aniridic, 1 juvenile, and 1 associated with Stage IV retinopathy of prematurity. The rate of failure due to encapsulation was 75% in eyes with SWS versus 18% in all other diagnoses (p = 0.00003, X(2) test). Failure occurred at a mean of 3 years after implantation in SWS (range 10 months-6 years), and at 1 year in all other diagnoses (range 3 months-3.3 years). Conclusions: Tube shunt devices fail from encapsulation frequently in pediatric glaucoma patients. Late failure due to encapsulation appears more frequently in SWS than in other pediatric glaucomas. This increased rate of encapsulation may be related to differences in episcleral and subconjunctival healing and wound repair, possibly related to episcleral vascular abnormalities.
M.R. Khitri.
Classification:
12.8.2 With tube implant or other drainage devices (Part of: 12 Surgical treatment > 12.8 Filtering surgery)
9.4.15 Glaucoma in relation to systemic disease (Part of: 9 Clinical forms of glaucomas > 9.4 Glaucomas associated with other ocular and systemic disorders)
9.1.2 Juvenile glaucoma (Part of: 9 Clinical forms of glaucomas > 9.1 Developmental glaucomas)
