Results of childhood glaucoma surgery over a long-term period.
Hoffmann Esther M, Aghayeva Fidan, Schuster Alexander K, Pfeiffer Norbert, Karsten Mona, Schweiger Susann, Pirlich Nina, Wagner Felix M, Chronopoulos Panagiotis, Grehn Franz
AI Summary
Childhood glaucoma surgeries effectively reduced eye pressure long-term in both congenital and secondary cases, with 360° catheter-assisted trabeculotomy showing the most promising results.
Abstract
Purpose
To evaluate long-term results of glaucoma surgery in newborn and infants with glaucoma.
Methods
Seventy-nine eyes of 52 children (age: 3 weeks-15.3 years) with primary congenital or secondary glaucoma treated between 2015 and 2017 were included. The median follow-up time was 3.9 years. Conventional probe trabeculotomy, 360° catheter-assisted trabeculotomy, filtering and cyclodestructive surgery were compared. Strict criteria for surgical success were applied: Complete surgical success (IOP below target IOP, no further surgery) and incomplete surgical success (additional surgery allowed) were analyzed, and IOP at baseline and last follow-up was compared.
Results
Intraocular pressure (IOP) was significantly reduced in primary congenital (preoperative IOP: 27.8 ± 7.5 mmHg vs. postoperative IOP: 14.2 ± 4.5 mmHg) and secondary glaucoma (preoperative IOP: 29.2 ± 9.1 mmHg vs. postoperative IOP: 16.6 ± 4.7 mmHg). 90% of all eyes reached target IOP with or without medication allowing for additional surgeries. As first surgery, 360° catheter-assisted trabeculotomy had a tendency to higher surgical success than other surgical approaches, while cyclodestructive procedures had lowest.
Conclusions
We found very promising surgical results in our childhood glaucoma patient group. Surgical success in both congenital and secondary glaucoma was high.
MeSH Terms
Shields Classification
Key Concepts5
Intraocular pressure (IOP) in primary congenital glaucoma was significantly reduced from a preoperative mean of 27.8 7.5 mmHg to a postoperative mean of 14.2 4.5 mmHg in 79 eyes of 52 children (age: 3 weeks-15.3 years) with primary congenital or secondary glaucoma.
Intraocular pressure (IOP) in secondary glaucoma was significantly reduced from a preoperative mean of 29.2 9.1 mmHg to a postoperative mean of 16.6 4.7 mmHg in 79 eyes of 52 children (age: 3 weeks-15.3 years) with primary congenital or secondary glaucoma.
90% of all eyes (79 eyes of 52 children) reached target IOP with or without medication, allowing for additional surgeries, after glaucoma surgery in newborn and infants with primary congenital or secondary glaucoma.
As a first surgery for childhood glaucoma, 360 catheter-assisted trabeculotomy showed a tendency to higher surgical success compared to other surgical approaches (conventional probe trabeculotomy, filtering, and cyclodestructive surgery) in 79 eyes of 52 children with primary congenital or secondary glaucoma.
Cyclodestructive procedures had the lowest surgical success as a first surgery for childhood glaucoma compared to other surgical approaches (conventional probe trabeculotomy, 360 catheter-assisted trabeculotomy, and filtering surgery) in 79 eyes of 52 children with primary congenital or secondary glaucoma.
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