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Outcome of surgical treatment of primary and secondary glaucoma in young children

Journal article
Authors Madeleine Zetterberg
Alf Nyström
Lada Kalaboukhova
Gunilla Magnusson
Published in Acta Ophthalmologica
Volume 93
Issue 3
Pages 269-275
ISSN 1755-375X
Publication year 2015
Published at Institute of Neuroscience and Physiology, Department of Clinical Neuroscience and Rehabilitation
Pages 269-275
Language en
Links dx.doi.org/10.1111/aos.12566
Keywords aphakic glaucoma, congenital cataract, congenital glaucoma, glaucoma surgery, intraocular pressure, PRIMARY CONGENITAL GLAUCOMA, CHILDHOOD GLAUCOMA, CATARACT-SURGERY, VISUAL-ACUITY, PEDIATRIC GLAUCOMA, EXPERIENCE, INFANTILE, ANGLE, EYE, Ophthalmology
Subject categories Ophthalmology

Abstract

PurposeTo describe a paediatric cohort surgically treated for primary or secondary glaucoma (PG/SG), with regard to incidences, visual outcome and control of intraocular pressure (IOP). MethodsAll children (n=29, 42 eyes in total) surgically treated for PG or SG at the age of 4years or younger between January 2002 and December 2010 at Sahlgrenska University Hospital in Molndal were retrospectively studied through medical records. Median follow-up time after initial surgery was 5.9years (range 2.4-11.2years). ResultsThe incidence of primary congenital glaucoma was 4.3 cases per 100000 live births in the county of Vastra Gotaland. For glaucoma secondary to cataract surgery, the incidence was 13% with a median postoperative duration to diagnosis of glaucoma of 3.8months (range 1.6months to 4.3years). Preoperative mean IOP was 31.5 (SD 8.1) mmHg, and mean IOP at last visit was 17.1 (SD 4.4) mmHg. For the entire cohort, 30% of the glaucoma eyes required more than two IOP-lowering surgical procedures during the study period. BCVA was 0.3 (decimal) in 45% of glaucomatous eyes at last follow-up with no statistically significant difference between PG and SG. Analysis of functional visual outcome, that is BCVA in the better eye, showed that 83% of all patients attained a BCVA of 0.5. ConclusionsThe incidences and outcome of surgically treated paediatric glaucoma were in accordance with previous studies. Chamber angle surgery, and if necessary, tube implantation without the use of antimetabolites, is a favourable approach leaving most sites needed for future glaucoma surgery unaffected.

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