Delayed suprachoroidal hemorrhage after pediatric glaucoma surgery

INTRODUCTION The purpose of this stud), was to identify surgical risk factors for delayed suprachoroidal hemorrhage after glaucoma surgery in children. METHODS A retrospective literature review (1966-2008) of pediatric glaucoma surgery outcomes (performed in patients <18 years of age) was conducted; cases of delayed suprachoroidal hemorrhage were identified and reviewed. RESULTS The literature review identified 2,491 surgeries, from which 9 cases of delayed suprachoroidal hemorrhage (9/2,491, 0.36%) were documented in 5 case series. Six (4 documented aphakic, 2 possibly aphakic) occurred after Ahmed valve implantation (6/389, 1.5%; 2 of the 6 cases associated with intraoperative mitomycin-C use). The other 3 (all 3 possibly aphakic) occurred after trabeculectomy antimetabolite (3/741, 0.4%). CONCLUSIONS There are few reports of pediatric delayed suprachoroidal hemorrhage. The greatest risk for this complication seems to be after Ahmed valve implantation in the setting of aphakia. Because intraoperative mitomycin-C use may increase the risk for pediatric delayed suprachoroidal hemorrhage after Ahmed valve implantation, mitomycin-C should not be applied in this setting without evidence for improved valve function from its use. (J AAPOS 2009,13:283-286)