[Congenital glaucoma: future of vision and pressure. Results of an 11-year study]

To study the future of vision and IOP in congenital glaucoma.

We studied 33 eyes from 20 separate patients divided into two groups: group one consisted of 19 eyes with isolated trabeculodysgenesis and group two 14 eyes associated with Sturge-Weber-Krabbe syndrome, angiomatosis, or Peters syndrome. All patients underwent filtering surgery between 1995 and 2006. We studied a number of different forms of surgery; visual acuity after amblyopia treatment (> or =5/10, good; 4/10-2/10, average; < or =1/10, poor), objective refraction, and intraocular pressure (<16 mmHg, good; > or =16 mmHg, poor).

We found that 54.8% of the patients had visual acuity 5/10 or greater and 44.2% between 4 and the ability to perceive light. Objective refraction was emmetropic in 19.4% (group 1, 60%; group 2, 40%), myopic in 53.8% (group 1, 28.5%; group 2, 71%), and hyperopic in 26.9% of cases (100%, group 1). All patients underwent surgery (45.5% deep sclerectomy and 54.5% trabeculectomy); 39.4% of the patients underwent more than one type of surgery (the number of operations is a prognosis factor for visual acuity). IOP was less than 19 mmHg in 87.9% of eyes.

Visual acuity, refractive errors, and IOP depend on the type of congenital glaucoma. Isolated trabeculodysgenesis seems to give a better prognosis.

If early diagnosis and treatment occur, visual acuity that is 5/10 or less can be expected for more than 50% of patients; therefore their visual future seems to be better.