Silicone Oil and Glaucoma-Related Adverse Events in Pediatric Vitreoretinal Surgery.

Q2 Medicine

Ophthalmology. Glaucoma Pub Date : 2025-03-21 DOI:10.1016/j.ogla.2025.03.006

Meghan Sharma, Laura Huertas, David J Taylor Gonzalez, Roya Garakani, Audina M Berrocal, Ta C Chang

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Abstract

Purpose: This study aims to assess the risk of glaucoma-related adverse events (GRAEs) in pediatric patients following silicone oil use in vitreoretinal (VR) surgery, positing that silicone oil exposure increases GRAE risk.

Design: A single-center retrospective cohort study at a tertiary care facility.

Participants: Pediatric patients aged 0 to 18 years who underwent VR surgery between April 2019 and April 2021 were included. Patients with previously diagnosed glaucoma or who had undergone glaucoma surgery were excluded.

Methods: Review of medical records for intraoperative use of silicone oil and postoperative occurrence of GRAE, defined as elevated intraocular pressure (>21 mmHg), initiation of pressure-lowering medications, performance of pressure-lowering surgery, or a diagnosis of childhood glaucoma based on the Childhood Glaucoma Research Network criteria.

Main outcome measures: Survival analysis of GRAE between patients exposed vs. not exposed to silicone oil during VR surgery.

Results: Of the 186 pediatric patients analyzed, 64 (34.4%) were exposed to silicone oil, and 102 developed GRAE (54.8%). Median survival time to GRAE was 2.0 months (95% confidence interval [CI]: 0.3, 7.7) for silicone oil exposure in patients vs. 25.3 months (95% CI: 3.6, N/A) for patients not exposed to silicone oil (P = 0.0045). Patients exposed to silicone oil had a 52% increased risk of GRAE compared to those not exposed to silicone oil when adjusted for age at VR surgery (hazard ratio: 1.52 [95% CI: 1.01, 2.28], P = 0.0425).

Conclusions: In this exploratory study, GRAE was commonly observed following pediatric VR surgery, particularly in patients exposed to silicone oil. These findings underscore the importance of careful glaucoma surveillance following VR surgery in children.

Financial disclosure(s): Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.

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硅油与青光眼相关的儿童玻璃体视网膜手术不良事件。

目的：本研究旨在评估硅油在玻璃体视网膜（VR）手术中使用后儿科患者青光眼相关不良事件（GRAE）的风险，假设硅油暴露会增加GRAE风险。设计：在三级医疗机构进行回顾性队列单中心研究。参与者：包括在2019年4月至2021年4月期间接受VR手术的0-18岁儿科患者。先前诊断为青光眼或曾接受过青光眼手术的患者被排除在外。方法：回顾术中使用硅油和术后发生GRAE的医疗记录，GRAE定义为眼压升高（>21 mm Hg），开始使用降压药物，进行降压手术，或根据儿童青光眼研究网络标准诊断为儿童青光眼。主要结局指标：VR手术中暴露与未暴露硅油患者GRAE的生存分析。结果：186例患儿中，64例（34.4%）暴露于硅油，102例（54.8%）发生GRAE。硅油暴露患者到gre的中位生存时间为2.0个月（95% CI: 0.3, 7.7），而未暴露硅油的患者为25.3个月（95% CI: 3.6, N/A）（p=0.0045）。在VR手术中，与未接触硅油的患者相比，接触硅油的患者发生GRAE的风险增加了52% （HR:1.52 [95% CI: 1.01, 2.28], p = 0.0425）。结论：在这项探索性研究中，GRAE在儿童VR手术后普遍存在，特别是在接触硅油的患者中。这些发现强调了儿童VR手术后仔细监测青光眼的重要性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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