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Abstract #6756 Published in IGR 4-1
Management of refractory glaucoma in childhood
Terraciano AJ; Sidoti PACurrent Opinions in Ophthalmology 2002; 13: 97-102
Glaucoma in children is characterized by marked intraocular pressure (IOP) elevation with resultant atrophy of the optic nerve and loss of retinal ganglion cells. In very young children, secondary expansion of the globe with damage to anterior segment structures, such as the cornea and zonule, often occurs. Permanent, severe visual dysfunction may result from optic nerve damage as well as from amblyopia arising from anisometropia and corneal opacification. The treatment of childhood glaucoma often involves surgery. Goniotomy and trabeculotomy remain the first line surgical procedures for open-angle glaucoma in children. Trabeculectomy with adjunctive antifibrosis therapy, aqueous shunt surgery, and cyclodestructive procedures are undertaken when angle surgery fails to control the IOP or is unlikely to succeed. The choice of surgical procedure is individualized according to factors such as the age of the patient, the specific type of glaucoma, the number of prior surgical procedures, and the visual potential of the eye. Achieving and maintaining an adequate IOP to prevent progressive optic nerve damage, avoiding complications, and preserving vision are the goals that must be considered in deciding on a surgical plan.
Dr. P.A. Sidoti, Department of Ophthalmology, 310 East 14th Street, New York, NY 10003, USA. psidoti@nyee.edu
Classification:
9.1 Developmental glaucomas (Part of: 9 Clinical forms of glaucomas)
12.1 General management, indication (Part of: 12 Surgical treatment)
