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

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.