Epidemiology and long-term outcomes of primary congenital glaucoma: a population-based study.
Nutt Robert John, Dowlut Mohammad Samir, McLoone Seán Francis, McLoone Eibhlin
AI Summary
This study found primary congenital glaucoma is highly prevalent in the Irish Traveller community, but good long-term vision is achievable for most patients despite challenging management and multiple surgeries.
Abstract
Background/objectives: to establish the incidence, prevalence and long-term outcomes of primary congenital glaucoma (PCG) in Northern Ireland's general and Irish Traveller (IT) populations over a 59-year period.
Subjects/Methods
chart review of all PCG cases in Northern Ireland between 1962 and 2020. Incidence and prevalence were calculated with the aid of national population statistics. Long-term outcomes were analysed for eyes with at least 5 years follow up. Visual outcomes were stratified into groups: good-VA ≥ 6/12; moderate-VA 6/12 to 6/60, poor-VA < 6/60. Kaplan-Meier analysis was constructed to determine the probability of eyes retaining a good visual outcome over time. Outcomes of different surgeries were compared with regard to final vision, re-operations and complications.
Results
57 PCG cases were identified between 1962 and 2020. Overall incidence was 3.4 per 100,000 live births. PCG prevalence in general and IT populations in 2019 was 4.3 per 100,000 and 238 per 100,000, respectively. Sixty eyes had sufficient data for long-term outcome analysis with a mean of 20.5 years follow up, 58% of which had good final visual outcome. Fifty-seven percent of eyes required multiple surgeries. Visual outcomes between trabeculectomies and tubes were comparable; however, there were more serious complications and reoperations associated with tubes.
Conclusions
Incidence of PCG in NI is similar to Great-Britain and Ireland; however, PCG appears to be particularly prevalent within IT community. Although a good visual outcome can be achieved in the majority of patients, a subset of cases remain challenging to manage despite surgical advances.
MeSH Terms
Shields Classification
Key Concepts4
The overall incidence of primary congenital glaucoma (PCG) in Northern Ireland between 1962 and 2020 was 3.4 per 100,000 live births.
The prevalence of primary congenital glaucoma (PCG) in the general population of Northern Ireland in 2019 was 4.3 per 100,000, while in the Irish Traveller (IT) population it was 238 per 100,000.
Among 60 eyes with primary congenital glaucoma (PCG) in Northern Ireland with a mean of 20.5 years follow-up, 58% achieved a good final visual outcome (VA ≥ 6/12).
Visual outcomes between trabeculectomies and tubes for primary congenital glaucoma (PCG) were comparable; however, tube surgeries were associated with more serious complications and reoperations.
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