Journal: |
journal of ophthalmology
hindawi
|
Volume: |
|
Abstract: |
Purpose. To evaluate the safety and efficacy of a novel modified subscleral trabeculectomy technique in management of primary
congenital glaucoma. Methods. )is study included 25 infants diagnosed of having bilateral primary congenital glaucoma. For
each patient, one eye was assigned to undergo subscleral trabeculectomy with trimming of the edges of the scleral bed (group I),
while the contralateral eye underwent subscleral trabeculectomy with application of mitomycin C (0.4 mg/ml for 3 min) (group
II). All the patients were followed up for a period of 14 ± 3 months (range 13–22 months). Results. 25 eyes were included in each
group. Patients’ mean age was 2.5 ± 0.5 months (range 1.8–6.5 months). )e mean preoperative intraocular pressure was
31 ± 4.9 mmHg and 32.1 ± 4.0 mmHg in group I and II, respectively. )e mean postoperative intraocular pressure was 9.0 ± 1.0,
11.0 ± 3.2, 12.5 ± 0.9, 13.0 ± 2.9, and 15.5 ± 1.5 mm Hg in group I and was 10.3 ± 1.2, 12.0 ± 2.5, 13.5 ± 1.7, 15.0 ± 1.5, and
17.1 ± 2.8 mm Hg in group II at the first week and 1, 3, 6, and 12 months, respectively. )ere was no statistically significant
difference between the mean intraocular pressure values recorded at both groups preoperatively and at each follow-up visit.
Failure necessitating further surgical interventions was recorded in 4 eyes (16%) in group I as compared to 3 eyes (12%) in group II
(P > 0.05). Postoperative complications included mild hyphema, which occurred in one eye (4%) in group I and 2 eyes (8%) in
group II, and shallow anterior chamber in 3 eyes (12%) in group I and in 2 eyes (8%) in group II. One eye (4%) in group I
developed drawn-up pupil. Choroidal effusion developed in one eye (4%) at each group. Conclusion. Trimming the edges of the
scleral bed adjacent to the sclera flap is a safe and effective surgical step which can be added to the subscleral trabeculectomy
procedure to effectively control the intraocular pressure in patients with primary congenital glaucoma, sparing them the hazards
associated with mitomycin C application.
|
|
|