Purpose: Laser photocoagulation is the current treatment standard for severe retinopathy of prematurity (ROP). Uncommon, but well recognized complications include cataract, and vitreous and retinal hemorrhage. Angle-closure glaucoma after laser photocoagulation for ROP is rare. The purpose of this study was to identify additional cases of angle-closure glaucoma following laser treatment for ROP.
Methods: Five eyes of four patients with angle-closure glaucoma following laser treatment for ROP were identified by three ophthalmologists at separate institutions between 1997 and 2001. Demographic and clinical data were obtained from medical records. Clinical and surgical findings associated with the diagnosis and management of angle-closure glaucoma following ROP laser were evaluated.
Results: The following data were collected (mean (range)): gestational age, 26.8 (24 to 29) weeks; birth weight, 833 (570 to 1062) g; age at laser treatment for ROP, 35 (33 to 37) weeks; number of laser burns, 1598 (930 to 2400); and time to diagnosis of angle-closure glaucoma, 3.6 (2 to 5) weeks. Three of five eyes had objective data for intraocular pressure (IOP) and corneal diameter with mean IOP 41 mm Hg (35 to 44) and mean corneal diameter 11.1 mm (10.25 to 11.5). Initial treatment included topical and systemic medications. Three eyes required surgical intervention. Angle-closure resolved in all cases with normalization of IOP. Follow-up (5 months to 3.6 years) showed that affected eyes tended to be more myopic than unaffected fellow eyes (mean spherical equivalent -6.5 vs -4.7 diopters).
Conclusions: Angle-closure glaucoma can develop following laser treatment for severe ROP. Medical, and frequently surgical, intervention provides effective management.