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Abstract #74153 Published in IGR 19-1
Early Trabeculotomy Ab Externo in Treatment of Sturge-Weber Syndrome
Wu Y; Yu R; Chen D; Xu L; Zhu L; Li M; Guo C; Gu P; Lin X; Guo WAmerican Journal of Ophthalmology 2017; 182: 141-146
PURPOSE: To evaluate the intermediate-term efficacy and safety of trabeculotomy in infant Sturge-Weber syndrome (SWS). DESIGN: Retrospective cohort study. METHODS: All SWS-induced glaucoma patients less than 12 months of age who underwent trabeculotomy at our Ophthalmology Department from August 2011 to March 2017 were reviewed. Baseline demographics, intraocular pressure (IOP), cup-to-disc ratio (C/D), and cornea diameters were noted before surgery. The IOP, success probabilities, and medication usage were recorded during follow-up until the last visit. RESULTS: Overall, 34 eyes (32 patients) were included, with a median surgery age of 3 months and a median follow-up time of 15.5 months. The mean preoperative IOP, asymmetry between 2 eyes, cornea diameter, and median C/D were 21.5 ± 6.6 mm Hg, 10.1 ± 4.9 mm Hg, 12.6 ± 0.7 mm, and 0.65 (interquartile range [IQR]: 0.55, 0.80), respectively. The IOP was significantly reduced from the preoperative baseline at 1 week, 3 months, 6 months, 1 year, and 2 years after the surgery (P < .05). At the last follow-up, the cumulative proportions of overall and complete success were 86.6% and 66.0%, respectively. Complications included a transient shallow anterior chamber. Thirty of the 34 eyes had intraoperative hyphema, 27 of which lasted less than 3 days. No other complications were noted during the follow-up. CONCLUSIONS: Compared to previous studies with a later diagnosis of glaucoma in SWS patients, better outcomes were achieved with an early diagnosis of glaucoma in SWS patients. Early trabeculotomy ab externo was safe and led to good intermediate-term surgical outcomes for early-onset glaucoma in SWS patients. Higher preoperative IOP and corneal edema were associated with a greater risk of surgery failure.
Department of Ophthalmology, Ninth People's Hospital Affiliated With Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Full articleClassification:
12.9 Trabeculotomy, goniotomy (Part of: 12 Surgical treatment)
12.8.3 Non-perforating (Part of: 12 Surgical treatment > 12.8 Filtering surgery)
9.4.15 Glaucoma in relation to systemic disease (Part of: 9 Clinical forms of glaucomas > 9.4 Glaucomas associated with other ocular and systemic disorders)
