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Abstract #20047 Published in IGR 9-4
Nonpenetrating external trabeculectomy for congenital glaucoma: A retrospective study
Roche O; Beby F; Parsa A; Orssaud C; Dufier JL; Parsa CFOphthalmology 2007; 114: 1994-1999
OBJECTIVE: To evaluate the results of nonpenetrating external trabeculectomy (NPET) for primary congenital glaucoma (CG). DESIGN: Retrospective, noncomparative, interventional case series. PARTICIPANTS: Forty-three eyes of 27 consecutive patients with primary CG. METHODS: Initial intent of NPET with intraoperative conversion to trabeculectomy in cases where aqueous humor outflow was deemed insufficient or where Schlemm's canal appeared to be absent. MAIN OUTCOME MEASURES: Intraocular pressure (IOP). Success was defined as an IOP less than 12.5 mmHg at one year after the procedure or later, using adjunctive pressure-lowering topical medications whenever needed. RESULTS: Mean initial measures of IOP were 18.8 mmHg. Of the 43 eyes, a total of 13 required conversion to trabeculectomy: nine because of insufficient filtration, three because of an apparent absence of Schlemm's canal, and one because of accidental perforation. Of these 13 eyes that ultimately underwent trabeculectomy, 11 achieved successful IOP control, three in association with topical therapy. In one eye, a retinal detachment developed, and in seven eyes, other complications were observed. Among the 30 remaining eyes that underwent NPET, two underwent the procedure twice, and one eye underwent the procedure three times. Postoperative complications were not noted in this NPET-only group. Mean postoperative IOP was 10.8 mmHg, with final IOP controlled in 28 of the 30 eyes (93%; P < 0.0001), occasionally after repeat surgeries and in combination with topical therapy. CONCLUSIONS: Nonpenetrating external trabeculectomy may be considered as an initial procedure for some cases of primary CG. It appears to be an alternative to trabeculectomy with fewer risks of postoperative complications.
Dr. O. Roche, Service d'Ophtalmologie, Hôpital Necker-Enfants Malades, Paris, France. Oph.roche@free.fr
Classification:
9.1.1 Congenital glaucoma, Buphthalmos (Part of: 9 Clinical forms of glaucomas > 9.1 Developmental glaucomas)
12.8.3 Non-perforating (Part of: 12 Surgical treatment > 12.8 Filtering surgery)