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Abstract #3656 Published in IGR 4-2
Risk profile of deep sclerectomy for treatment of refractory congenital glaucomas
Luke C; Dietlein TS; Jacobi PC; Konen W; Krieglstein GKOphthalmology 2002; 109: 1066-1071
OBJECTIVES: To evaluate the effectiveness and risk profile of deep sclerectomy in surgery for refractory congenital glaucoma. DESIGN: Retrospective non-comparative interventional case series. PARTICIPANTS AND INTERVENTIONS: Ten eyes of eight consecutive patients underwent deep sclerectomy for refractory congenital glaucoma. The procedure was converted to a trabeculectomy in four eyes and supplemented by a trabeculotomy in two eyes. Six eyes had primary congenital glaucoma, and four had secondary congenital glaucoma. The patients' ages at the time of surgery in our department ranged from eight months to 14 years. All eyes had a history of previous glaucoma surgery. MAIN OUTCOME MEASURES: The surgical outcome was assessed in terms of complication rate, intraocular pressure (IOP) change, need for surgical revision, or additional glaucoma medication. RESULTS: Preoperatively, the mean IOP was 31.9 mmHg (standard deviation (SD), 5.6 mmHg). At the first follow-up one week after surgery, the mean IOP for all eyes was 12.7 mmHg (SD, 6.8 mmHg). The average reduction of IOP was statistically significant (p < 0.001). In accordance with the success criteria, all eyes were ultimately classified as failures. Average time to failure was 2.1 months (SD, 3.6 months). Specific complications were seen in terms of non-identification of Schlemm's canal (40%), choroidal deroofing (10%), and visible perforation of the trabeculodescemetic membrane (20%). Further complications were hyphema (40%), ocular hypotony (10%), vitreous hemorrhage (10%), and vitreous loss with subsequent retinal detachment (10%). CONCLUSIONS: Although deep sclerectomy may reduce the IOP in patients with refractory congenital glaucoma, this study indicates a specific risk profile associated with deep sclerectomy in surgery for refractory congenital glaucoma.
Dr. C. Luke, Zentrum fur Augenheilkunde, Universität Koln, Cologne, Germany
Classification:
12.8.3 Non-perforating (Part of: 12 Surgical treatment > 12.8 Filtering surgery)
