Assessing the need for posterior sclerotomy at the time of filtering surgery in patients with Sturge-Weber syndrome.

PURPOSE: Posterior sclerotomy has been recommended for prevention of intraoperative choroidal hemorrhages and choroidal effusions in patients with Sturge-Weber syndrome (SWS) or Klippel-Trenaunay-Weber (KTW) syndrome undergoing glaucoma filtering surgery. In this study, we evaluated this unproven clinical perception.

DESIGN: A retrospective, noncomparative, case series.

PARTICIPANTS: Seventeen consecutive patients with SWS or KTW syndrome who underwent glaucoma filtering surgery without prophylactic posterior sclerotomy or other prophylactic measures between January 1973 and March 1997 at a university-based practice.

INTERVENTION: Glaucoma filtering surgery without prophylactic posterior sclerotomy.

MAIN OUTCOME MEASURES: Incidence of intraoperative and postoperative choroidal effusion, choroidal detachment, or choroidal hemorrhage.

RESULTS: No intraoperative choroidal effusion, choroidal detachment, or choroidal hemorrhage occurred in this series. After surgery, 6 patients had a transient choroidal effusion. Surgical drainage was not required in any of them. No suprachoroidal hemorrhages occurred after surgery.

CONCLUSIONS: We did not encounter significant intraoperative suprachoroidal hemorrhage, choroidal effusions, or a combination requiring therapeutic intervention in our series. This finding leads us to question the necessity for prophylactic posterior sclerotomy to prevent the occurrence of these complications in patients with SWS and KTW syndrome undergoing glaucoma filtering surgery.