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Augmented trabeculectomy in paediatric glaucoma

R Ehrlich1, M Snir, M Lusky

  • 1Department of Ophthalmology, Rabin Medical Center, Beilinson Campus, Petah Tiqva 49 100, Israel. ehrlichy@netvision.net.il

The British Journal of Ophthalmology
|January 25, 2005
PubMed

Insights

Augmented trabeculectomy using mitomycin C and 5-fluorouracil effectively lowered intraocular pressure in pediatric glaucoma patients. This surgical approach shows promise as a primary treatment for selected young individuals with glaucoma.

Area of Science:

  • Ophthalmology
  • Surgical Innovation
  • Pediatric Glaucoma Management

Background:

  • Pediatric glaucoma presents unique management challenges.
  • Trabeculectomy is a common glaucoma surgery, but augmentation may improve outcomes.
  • Mitomycin C and 5-fluorouracil are antimetabolites used to enhance surgical success.

Purpose of the Study:

  • To evaluate the efficacy and safety of trabeculectomy augmented with mitomycin C and 5-fluorouracil in treating pediatric glaucoma.
  • To assess the impact on intraocular pressure, visual acuity, and optic nerve status.
  • To determine the long-term success rates and complication profile of this combined surgical approach.

Main Methods:

  • A retrospective, interventional case series was conducted.
  • Seventeen children (29 eyes) with primary or secondary glaucoma underwent augmented trabeculectomy.
  • Data collected included preoperative/postoperative intraocular pressure, visual acuity, optic disc status, and complications.

Main Results:

  • Intraocular pressure significantly decreased from a mean of 33.1 mmHg to 17.1 mmHg (p <0.0001).
  • Successful intraocular pressure control (<20 mmHg) was achieved in 75.8% of eyes, with a 3-year success rate of 86%.
  • Complications were infrequent, including retinal detachment, choroidal detachment, and blebitis in isolated cases.

Conclusions:

  • Augmented trabeculectomy with mitomycin C and 5-fluorouracil is a viable primary surgical option for select pediatric glaucoma patients.
  • The procedure demonstrated significant intraocular pressure reduction and acceptable safety profile.
  • Further research may refine patient selection for optimal outcomes.
Abstract

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