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Abstract #26703 Published in IGR 12-3
Outcome of angle surgery in children with aphakic glaucoma
Bothun ED; Guo Y; Christiansen SP; Summers CG; Anderson JS; Wright MM; Kramarevsky NY; Lawrence MGJournal of AAPOS 2010; 14: 235-239
Purpose: To investigate the outcome of trabeculotomy and/or goniotomy for pediatric aphakic glaucoma. Methods: Retrospective chart review of consecutive children who had congenital cataract surgery between 1990 and 2006 and required goniotomy and/or trabeculotomy for aphakic glaucoma. Treatment success was defined as postoperative intraocular pressure of (less-than or equal to)24 mm Hg despite topical medication use, avoidance of trabeculectomy or shunt placement, and no visually significant complications in the follow-up period. Exclusion criteria included a diagnosis of anterior segment dysgenesis, microcornea, and glaucoma at the time of cataract surgery, and follow-up less than 1 year. Results: A total of 14 eyes of 11 patients met inclusion criteria, with a mean follow-up of 4.7 years. Of theses, 2 eyes had goniotomy alone, 3 eyes had goniotomy followed by trabeculotomy, and 9 eyes had trabeculotomy alone. Mean IOP before angle surgery was 35 (plus or minus) 10 mm Hg. Mean IOP at the last recorded visit was 22 (plus or minus) 4 mm Hg (p = 0.0005). Treatment success was observed in 8 of the 14 eyes (57.1%), with a mean number of angle procedures of 1.4 per eye: 6 eyes (42.8%) were successful after a single angle surgery, each involving an initial trabeculotomy; 3 eyes (21.4%) underwent subsequent shunt placement after initial goniotomy at 6 months, 1.3 years, and 5.5 years after the last angle surgery. Conclusions: When intraocular surgery is indicated to control IOP in pediatric aphakic glaucoma, trabeculotomy and/or goniotomy can be successful in the majority of eyes and may decrease the need for filtering and shunting procedures.
E. D. Bothun. Pediatric Ophthalmology and Adult Strabismus, Department of Ophthalmology, University of Minnesota, 420 Delaware Street SE, MMC #493, Minneapolis, MN 55455-5501, United States. bothu003@umn.edu
Classification:
9.4.11.2 Glaucomas in aphakia and pseudophakia (Part of: 9 Clinical forms of glaucomas > 9.4 Glaucomas associated with other ocular and systemic disorders > 9.4.11 Glaucomas following intraocular surgery)
9.1.2 Juvenile glaucoma (Part of: 9 Clinical forms of glaucomas > 9.1 Developmental glaucomas)
12.9 Trabeculotomy, goniotomy (Part of: 12 Surgical treatment)
