Decompression Retinopathy After Goniotomy in a Child: A Case Report.

Abstract

To report a case of ocular decompression retinopathy that developed in a child after undergoing goniotomy for uncontrolled pediatric uveitic glaucoma. We describe an 11-year-old Hispanic boy with a history of idiopathic uveitis and elevated intraocular pressure (IOP) in both eyes. He developed marked elevation of the IOP in the right eye (44 mm Hg) despite glaucoma medical therapy. The patient's right eye was treated with goniotomy, with reduction of vision to 20/70 and IOP to between 4 and 7 mm Hg during the first week postoperatively. The retina developed diffuse hemorrhages, both deep and superficial. Many of these hemorrhages had white centers. The findings were consistent with decompression retinopathy. The retinal hemorrhages began to improve 2 weeks and had cleared by 6 weeks after surgery. The IOP measurements ranged between 14 and 16 mm Hg from 2 to 6 weeks after goniotomy and the vision returned to preoperative baseline of 20/20-2 in the right eye. Six weeks after the initial surgery, the left eye was treated with goniotomy with no complications. Ocular decompression retinopathy, an uncommon complication of glaucoma surgery, can occur after goniotomy.