Related Experiment Video

Updated: Sep 28, 2025

Iris Fixation via External Pentagram Suturing
05:22

Iris Fixation via External Pentagram Suturing

Published on: May 5, 2022

1.5K

Outcomes of combined endoscopic vitrectomy and posteriorly placed glaucoma drainage devices in pediatric patients

A Jacobson1, C G Besirli1, B L Bohnsack2,3

  • 1Kellogg Eye Center, Department of Ophthalmology and Visual Sciences, University of Michigan, 1000 Wall Street, Ann Arbor, Michigan, 48105, USA.

BMC Ophthalmology
|April 2, 2022
PubMed

Insights

Combined endoscopic vitrectomy and glaucoma drainage devices (GDD) in pediatric glaucoma with corneal opacification show low success but aid IOP control. This approach may help preserve vision in complex cases requiring multiple interventions.

Area of Science:

  • Ophthalmology
  • Pediatric Glaucoma Management
  • Surgical Innovation

Background:

  • Pediatric glaucoma with corneal opacification presents significant management challenges.
  • Combined surgical approaches are being explored to address complex cases.

Purpose of the Study:

  • To describe outcomes of posteriorly-placed glaucoma drainage devices (GDD) combined with endoscopic vitrectomy in pediatric patients with glaucoma and corneal opacification.
  • To evaluate the efficacy and complications of this combined surgical technique.

Main Methods:

  • Retrospective case series of pediatric patients (<18 years) undergoing combined surgery (2012-2021).
  • Data included diagnoses, prior surgeries, GDD type/position, complications, and follow-up metrics (IOP, visual acuity, medications).
  • Success defined as IOP 5-21 mmHg without major complications or further glaucoma surgery.

Main Results:

  • Ten patients (14 eyes) with conditions like sclerocornea and Peters Anomaly underwent the procedure.
  • Only 4 eyes (3 patients) achieved success; 10 eyes required additional surgeries for glaucoma or hypotony.
  • 1- and 2-year survival rates were 36% and 18%, respectively, with a high rate of subsequent interventions.
  • Despite low initial success, 13/14 eyes achieved IOP control with fewer medications post-operatively.
  • Complications included retinal detachment, graft failure, phthisis, and band keratopathy.

Conclusions:

  • Combined endoscopic vitrectomy and posteriorly-placed GDD is a viable, though challenging, technique for pediatric glaucoma with corneal opacification.
  • The approach can help establish aqueous humor outflow and achieve IOP control, potentially preserving vision.
  • Multiple surgeries are often necessary, and the success rate is low, highlighting the complexity of these cases.
Abstract

Keywords:
Endoscopic vitrectomyGlaucoma drainage deviceMicrophthalmiaPediatric glaucomaPeters AnomalySclerocornea

More Related Videos

Retinal Pigment Epithelium Transplantation in a Non-human Primate Model for Degenerative Retinal Diseases11:20

Retinal Pigment Epithelium Transplantation in a Non-human Primate Model for Degenerative Retinal Diseases

Published on: June 14, 2021

3.9K
Full-Circle Cauterization of Limbal Vascular Plexus for Surgically Induced Glaucoma in Rodents10:10

Full-Circle Cauterization of Limbal Vascular Plexus for Surgically Induced Glaucoma in Rodents

Published on: February 15, 2022

1.5K

Related Concept Videos

Glaucoma: Overview01:25

Glaucoma: Overview

Glaucoma is an eye condition characterized by increased intraocular pressure that damages the retina and optic nerve, leading to irreversible blindness if left untreated. The human eye has various components, including the cornea, iris, pupil, lens, and optic nerve. Aqueous humor is secreted by the epithelium of the ciliary body in the posterior chamber and flows through the trabecular meshwork and canal of Schlemm, maintaining normal intraocular pressure. The trabecular meshwork and the canal...
926
Angle Closure Glaucoma: Treatment01:28

Angle Closure Glaucoma: Treatment

Angle-closure glaucoma, or closed-angle glaucoma, is an eye condition where the iris bulges out and blocks the iridocorneal angle, resulting in a buildup of aqueous humor and increased intraocular pressure. Immediate medical attention is necessary due to the sudden onset of symptoms. The treatment for angle-closure glaucoma includes short-term and long-term approaches. Short-term treatment involves using eye drops like pilocarpine to lower intraocular pressure by increasing aqueous humor...
845
Open Angle Glaucoma: Treatment01:27

Open Angle Glaucoma: Treatment

In open-angle glaucoma, the iridocorneal angle remains open, but the trabecular meshwork becomes stiff, slowing down the outflow of aqueous humor. This causes a buildup of aqueous humor in the anterior chamber, leading to a sudden increase in intraocular pressure. The treatment for open-angle glaucoma focuses on reducing the elevated intraocular pressure by either decreasing the secretion of aqueous humor or increasing its outflow.
Drugs such as carbonic anhydrase inhibitors, α2- and...
719