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Abstract #50976 Published in IGR 14-3
Trabeculectomy Versus Combined Trabeculotomy-Trabeculectomy in Pediatric Glaucoma
Lawrence SD; Netland PAJournal of Pediatric Ophthalmology & Strabismus 2012; 0: 1-7
PURPOSE:To compare outcomes between trabeculectomy and combined trabeculotomy-trabeculectomy in children with glaucoma. METHODS:This was a retrospective, comparative study of 40 eyes in 33 patients with pediatric glaucoma: 17 eyes treated with trabeculectomy and 23 eyes treated with combined trabeculotomy-trabeculectomy. Both groups were treated with intraoperative mitomycin C. Success was defined as intraocular pressure (IOP) of 21 mm Hg or less and greater than 5 mm Hg with no additional glaucoma surgery. RESULTS:Mean follow-up was 38.3 months. There was no significant difference in mean IOP lowering between groups during the follow-up period. Log-rank survival analysis showed a significantly higher success rate after combined surgery compared with trabeculectomy (P = .027). Treatment failures occurred in 5 patients with trabeculectomy and in 2 patients undergoing combined trabeculotomy-trabeculectomy. Failures resulted from increased IOP (n = 3) or hypotony (n = 4). There were no significant differences in complications observed after surgery in both groups. CONCLUSION:Trabeculectomy and combined trabeculotomy-trabeculectomy with mitomycin C were equally effective at lowering average IOP in children. Combined trabeculotomy-trabeculectomy was associated with greater long-term success.
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Classification:
9.1.2 Juvenile glaucoma (Part of: 9 Clinical forms of glaucomas > 9.1 Developmental glaucomas)
12.8.1 Without tube implant (Part of: 12 Surgical treatment > 12.8 Filtering surgery)
12.9 Trabeculotomy, goniotomy (Part of: 12 Surgical treatment)
