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Abstract #91418 Published in IGR 21-4
Long-Term Surgical Outcomes of Primary Congenital Glaucoma in a South Indian Population
Vimalanathan M; Gupta P; Vardhan SA; Pillai MR; Uduman MS; Krishnadas SR; Ehrlich JROphthalmology. Glaucoma 2020; 0:
PURPOSE: To evaluate the long-term surgical outcomes of children with primary congenital glaucoma (PCG) in a South Indian population. DESIGN: Retrospective cohort study. PARTICIPANTS: Children with PCG who underwent primary surgery from 1997 through 2000 at a tertiary eye center in India with minimum of 5 years of follow-up. METHODS: This retrospective cohort study included children with PCG who underwent trabeculotomy, trabeculectomy, or combined trabeculotomy and trabeculectomy (CTT) as primary surgery from 1997 through 2000 at a tertiary eye center in India with minimum of 5 years of follow-up. Survival analyses were performed to determine cumulative probability of complete and qualified success. MAIN OUTCOME MEASURES: Intraocular pressure (IOP) control, glaucoma medication use, surgical success rates, and complications. RESULTS: The study included 50 eyes of 31 patients. Mean age at initial surgery was 5 months (range, 5 days-48 months) and 19 patients (61.3%) showed bilateral disease. Mean duration of follow-up was 10.9 ± 3.10 years (range, 6-18 years). Mean IOP was reduced from 28.58 ± 9.78 mmHg (range, 10-59 mmHg) before surgery to 17.13 ± 7.62 mmHg after surgery (range, 5-42 mmHg; P < 0.001) at final follow-up. Survival analysis showed that the probability of surgical success with CTT was 77.8% at 1 year, 66.2% at 2 years, 53.0% at 5 years, and 16.6% at 15 years. Visual acuity at last available follow-up correlated with surgical success (P = 0.042). CONCLUSIONS: Surgical success after long-term follow-up of children with PCG is low. The probability of surgical success declines over time. Children with PCG require life-long follow-up and management, even after initial surgical success, to prevent visual impairment and blindness.
Department of Glaucoma, Aravind Eye Hospital Post Graduate Institute of Ophthalmology, Coimbatore, Tamil Nadu, India.
Full articleClassification:
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)
12.8.1 Without tube implant (Part of: 12 Surgical treatment > 12.8 Filtering surgery)
