Surgical Outcomes in Children With Primary Congenital Glaucoma: An Eight-Year Experience

Background Primary congenital glaucoma (PCG) is a congenital anomaly arising from an unusual development of the filtration angle, causing a remarkable rise in intraocular pressure (IOP) that is irrelevant to other ocular or systemic deformities. Purpose The aim of the current study was to evaluate the surgical outcome in PCG patients between 2011 and February 2019. Methods This was a retrospective study of PCG patients who underwent trabeculotomy, trabeculectomy, deep sclerectomy, Ahmed valve, and/or cyclophotocoagulation (CPC) at a tertiary hospital. The IOP must be equal or less than 21 mmHg with or without medication to be designated a successful surgery. Results A total of 80 eyes (41 patients) were included in the study, with a slight male predominance of 65.9%. At presentation, the most reported age group was under 30 days (46.3%). Moreover, deep sclerotomy was the most common procedure, followed by CPC, which were performed in 48 (58.5%) and 18 (21.9%) eyes, respectively. In the overall group, the mean initial IOP was 23.65±8.52 mmHg, while the mean IOP was 16.73±8.56 mmHg at final follow-ups (p < 0.001), with a 46% reduction. The mean axial length showed a slight progression from 21.11±2.58 at the initial visit to 22.92±3.57 mm at the last follow-up (p<0.001). However, the mean horizontal diameter increased from 12.63±1.83 mm at the initial visit to 13.31±1.13 mm at the final visit (p=0.004). Conclusion  An excellent IOP reduction could be accomplished in the majority of eyes. Deep sclerectomy can effectively reduce IOP in PCG without the occurrences of serious complications that are commonly seen after other procedures like trabeculectomy or trabeculotomy.