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C Shieh, A Agarwal, KA Tawansy, KM Joos; Pars Plana Vitrectomy and Glaucoma Shunt Placement for Pediatric Aphakic Glaucoma . Invest. Ophthalmol. Vis. Sci. 2002;43(13):639.
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Purpose: To determine if pars plana vitrectomy with a glaucoma shunt is a useful treatment for pediatric aphakic glaucoma. Methods: The outcomes of 16 eyes of 13 patients who underwent a combined vitrectomy and glaucoma shunt from February 1995 to December 2000 were reviewed. A complete pars plana vitrectomy was performed and a Baerveldt shunt was placed in the anterior chamber or in the pars plana. Results: Six of 16 eyes had failed trabeculectomy or cyclophotocoagulation preoperatively. Preoperative IOP averaged 33.4 + 5.4 mm Hg (range 25 - 44) on an average of 2.6 + 1.0 medications. Patients were followed postoperatively for an average of 30.9 + 28.8 months (range: 6- 79 months). Visual acuity remained stable or improved in 13 of 16 (81%) eyes. IOP remained controlled in 15 of 16 (94%) eyes, with an average IOP of 10.9 + 5.2 mmHg (range: 0-18 mmHg) on an average of 0.7 + 1.4 medications at the last examination. One patient underwent enucleation for an inoperable retinal detachment. Other postoperative complications included bilateral vitreous hemorrhages in one patient after head trauma, endophthalmitis in a micropthalmic eye 6 years after shunt placement, repositioning 2 tubes to a pars plana position after recurrent anterior erosions in one patient and fibrosis in another, pannus in 1 aniridic eye, and band keratopathy in a corneal graft. Conclusion: Combined pars plana vitrectomy and glaucoma shunt placement is a feasible option for treating aphakic pediatric glaucoma.
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