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[Intermediate results on the use of drainage devices for paediatric glaucoma]
T Colás-Tomás1, E Gutiérrez-Díaz, P Tejada-Palacios
1Servicio de Oftalmología, Hospital 12 de Octubre, Universidad Complutense, Madrid, España. teresacolas@hotmail.com
Insights
Glaucoma drainage devices (GDD) offer a viable surgical option for refractory pediatric glaucoma. Long-term success rates were 76% at six months, decreasing to 55% by 4-8 years, with a 41% failure rate.
Area of Science:
- Ophthalmology
- Pediatric Surgery
Background:
- Paediatric glaucoma presents unique challenges requiring effective management strategies.
- Glaucoma drainage devices (GDD) are considered for refractory cases when conventional treatments fail.
Purpose of the Study:
- To evaluate the efficacy and long-term complications of GDD implantation in children (0-15 years).
- To assess the probability of surgical success and intraocular pressure control post-GDD implantation.
Main Methods:
- Retrospective cohort study of 17 GDD implantations (Ahmed GDD and Molteno GDD) in 14 pediatric patients.
- Analysis of demographic data, glaucoma type, pre- and post-operative intraocular pressure (IOP), and follow-up duration.
Main Results:
- Congenital glaucoma (64.28%) and aphakic glaucoma (35.71%) were the primary indications.
- Median IOP reduced from 29.82 mmHg pre-operatively to 14.05 mmHg post-operatively.
- Kaplan-Meier analysis showed success rates of 76% (6 months), 63% (1-3 years), and 55% (4-8 years), with an overall GDD failure rate of 41.17%.
Conclusions:
- GDDs represent a valuable surgical intervention for refractory pediatric glaucoma.
- While initial success is high, long-term efficacy requires careful monitoring due to a significant failure rate.
Purpose:
To evaluate the results and long-term complications of glaucoma drainage devices (GDD) in paediatric patients (0-15 years).
Methods:
Retrospective cohort study was conducted on 17 implanted glaucoma drainage devices from July 1994 to April 2007 in 14 patients (17 eyes). In two patients (3 eyes) a Molteno GDD (MGDD) was implanted, and in 12 patients (14 eyes) an Ahmed GDD (AGDD) was used. We studied the demographic and glaucoma related patient data, as well as the probability of surgical success. The time which intraocular pressure (IOP) was controlled and the postoperative complications were also studied.
Results:
Of the fourteen patients, 9 (64.28%) showed congenital glaucoma, and 5 (35.71%) aphakic glaucoma. The pre-aqueous drainage device median IOP was 29.82 mmHg (SD: 6.98), and 14.05 mmHg (SD: 7.57) postoperative. The median follow-up was 3.14 years (3 months-8.3 years). Success of aqueous drainage device was defined as an IOP less than 21 mmHg with or without medication on the last two follow-up visits, and without severe complications or further glaucoma surgery. Using a Kaplan Meier analysis there was success in 76%, 63% and 55% at the six months, 1-3 years and 4-8 years respectively. The GDD was a failure in 41.17%.
Conclusions:
GDDs are a good surgery option for refractory paediatric glaucoma when other surgery procedures have failed or have bad prognosti.
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