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Abstract #46080 Published in IGR 13-2
Surgical outcomes with 360-degree suture trabeculotomy in poor-prognosis primary congenital glaucoma and glaucoma associated with congenital anomalies or cataract surgery
Beck AD; Lynn MJ; Crandall J; Mobin-Uddin OJournal of AAPOS 2011; 15: 54-58
Purpose: To evaluate the outcomes of 360-degree suture trabeculotomy in childhood glaucoma with poor prognosis. Methods: A nonrandomized, retrospective chart review was performed on pediatric patients (younger than 18 years of age) treated with a 360-degree suture trabeculotomy for glaucoma. The cases were categorized into the following groups: (1) primary congenital glaucoma with birth-onset presentation accompanied by corneal clouding noted at birth, (2) primary congenital glaucoma with onset or presentation after 1 year of age, (3) primary congenital glaucoma with previous failed goniotomy surgery, (4) infantile-onset glaucoma following congenital cataract surgery, and (5) infantile-onset glaucoma with associated ocular/systemic anomalies. Results: A total of 45 eyes of 33 patients were analyzed. The mean preoperative intraocular pressure (IOP) was 34.3 (plus or minus) 6.7 mm Hg on an average of 1.5 medications. Median age at time of surgery was 7 months. Mean final IOP (median last follow-up or failure, 12 months) was 22.2 (plus or minus) 7.1 mm Hg on an average of 1.5 medications. The probability of success according to time after surgery was 87% at 6 months, 63% at 1 year, and 58% at 2 years. Kaplan-Meier analysis of Groups 1-4 versus Group 5 failed to demonstrate a statistically significant difference (p = 0.13). Of 5 eyes with port wine mark-related glaucoma, 2 had a large (>50%), persistent postoperative hyphema, and concurrent vitreous hemorrhage. Conclusions: Children with a range of ocular pathologies can be successfully treated with 360-degree suture trabeculotomy. Further evaluation of this surgical technique in primary congenital glaucoma and open-angle glaucoma following congenital cataract surgery is warranted.
A. D. Beck. Emory Eye Center, 1365-B Clifton Rd, Atlanta, GA 30322, United States. Email: abeck@emory.edu
Classification:
9.1.1 Congenital glaucoma, Buphthalmos (Part of: 9 Clinical forms of glaucomas > 9.1 Developmental glaucomas)
12.9 Trabeculotomy, goniotomy (Part of: 12 Surgical treatment)