Outcome of angle surgery in children with aphakic glaucoma

Erick D. Bothun, Yan Guo, Stephen P. Christiansen, C. Gail Summers, Jill S. Anderson, Martha M. Wright, Natalia Y. Kramarevsky, Mary G. Lawrence

Research output: Contribution to journalArticlepeer-review

22 Scopus citations

Abstract

Purpose: To investigate the outcome of trabeculotomy and/or goniotomy for pediatric aphakic glaucoma. Methods: Retrospective chart review of consecutive children who had congenital cataract surgery between 1990 and 2006 and required goniotomy and/or trabeculotomy for aphakic glaucoma. Treatment success was defined as postoperative intraocular pressure of ≤24 mm Hg despite topical medication use, avoidance of trabeculectomy or shunt placement, and no visually significant complications in the follow-up period. Exclusion criteria included a diagnosis of anterior segment dysgenesis, microcornea, and glaucoma at the time of cataract surgery, and follow-up less than 1 year. Results: A total of 14 eyes of 11 patients met inclusion criteria, with a mean follow-up of 4.7 years. Of theses, 2 eyes had goniotomy alone, 3 eyes had goniotomy followed by trabeculotomy, and 9 eyes had trabeculotomy alone. Mean IOP before angle surgery was 35 ± 10 mm Hg. Mean IOP at the last recorded visit was 22 ± 4 mm Hg (p = 0.0005). Treatment success was observed in 8 of the 14 eyes (57.1%), with a mean number of angle procedures of 1.4 per eye: 6 eyes (42.8%) were successful after a single angle surgery, each involving an initial trabeculotomy; 3 eyes (21.4%) underwent subsequent shunt placement after initial goniotomy at 6 months, 1.3 years, and 5.5 years after the last angle surgery. Conclusions: When intraocular surgery is indicated to control IOP in pediatric aphakic glaucoma, trabeculotomy and/or goniotomy can be successful in the majority of eyes and may decrease the need for filtering and shunting procedures.

Original languageEnglish (US)
Pages (from-to)235-239
Number of pages5
JournalJournal of AAPOS
Volume14
Issue number3
DOIs
StatePublished - Jun 1 2010

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