The effects of external subretinal fluid drainage on secondary glaucoma in Coats' disease.

PURPOSE: We sought to investigate the effect of external subretinal fluid drainage (SRFD) on secondary or impending secondary glaucoma caused by bullous exudative retinal detachment for saving eyes with Coats' disease. METHODS: By retrospective chart review, we collected the treatment results of 56 patients younger than 15 years of age with Coats' disease. External SRFD was performed when exudative retinal detachment became bullous enough to cause anterior displacement of the lens-iris diaphragm or when secondary angle-closure glaucoma occurred. Treatment results were regarded as successful when secondary angle-closure glaucoma was prevented or responded to treatment. RESULTS: The mean age of those who underwent external SRFD was 3.1+/-1.8 years. Exudative retinal detachment was found in 48 eyes (86%), and external SRFD was needed initially in 19 (28%). External SRFD initially was performed in 19 eyes (28%) and in 2 (3%) after initial cryotherapy. Of these 21 eyes, no definite neovascular glaucoma was detected, and it took on average 1.2 SRFDs to treat or prevent secondary angle-closure glaucoma. All treatments were successful, and no eye was enucleated. CONCLUSIONS: External SRFD should be considered early as a treatment for secondary angle-closure glaucoma associated with bullous exudative retinal detachment in Coats' disease.