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Abstract #9220 Published in IGR 5-2
The Armenian Eye Care Project: surgical outcomes of complicated paediatric glaucoma
Hill R; Ohanesian R; Voskanyan L; Malayan ABritish Journal of Ophthalmology 2003; 87: 673-676
AIM: To review surgical results of the Armenian Eye Care Project's (AECP) efforts in pediatric glaucoma and to identify additional morbidity associated with its initial itinerant nature. METHODS: A non-randomized, retrospective historical cohort study of complicated pediatric glaucoma surgeries was performed by the AECP at the Republican Eye Hospital. Thirty-eight eyes of 34 pediatric patients underwent mitomycin C trabeculectomies (MMCT) (n = 20) or Ahmed glaucoma valve (AGV) placements (n = 18) for complicated pediatric glaucomas. The median age was 12.5 years, with a range of six to 17 years. Three clinical groups were represented: congenital glaucoma, Frank Kamenetsky syndrome (a glaucoma associated with uveitis), and Rieger's syndrome. RESULTS: Pre- and postoperative intraocular pressures were similar for the two groups (MMCT versus AGV = 30 versus 32 mmHg and 13.5 versus 14.8 mmHg, respectively; p > 0.05, t test). The AGV group was twice as likely to use medications postoperatively (44 versus 23%; p < 0.05, t test). The MMCT group was more likely to have a three line drop in visual acuity than the AGV group (28 versus 12%; p < 0.05, t test). The decreased visual acuity found postoperatively was most commonly secondary to cataract formation. CONCLUSIONS: Total success rates were similar in the two surgical treatment groups. These compared favorably with success rates reported for non-itinerant surgery. Postoperative complications worsened by the itinerant nature of the project were few and represented 5% of the total surgical interventions. Ultimately, the installation of fellowship trained specialists is the most effective approach to minimizing this problem and is recommended by the AECP as a strategy for developing and recovering countries.
Dr. R. Hill, Department of Ophthalmology, University of California, Irvine, CA 92697-4375, USA. tahill@uci.edu
Classification:
9.1 Developmental glaucomas (Part of: 9 Clinical forms of glaucomas)
12.8.2 With tube implant or other drainage devices (Part of: 12 Surgical treatment > 12.8 Filtering surgery)
12.8.10 Woundhealing antifibrosis (Part of: 12 Surgical treatment > 12.8 Filtering surgery)
