Goniotomy for Non-Infectious Uveitic Glaucoma in Children

Area of Science:

• Ophthalmology
• Pediatric Glaucoma Management
• Uveitis Complications

Background:

• Secondary glaucoma is a significant cause of blindness in childhood uveitis.
• Traditional surgeries like trabeculectomy have high re-intervention and complication rates.
• The impact of modern biologic therapies on surgical outcomes for pediatric uveitic glaucoma is unknown.

Purpose of the Study:

• To evaluate the efficacy and safety of goniotomy in pediatric non-infectious uveitis.
• To assess intraocular pressure (IOP) reduction and medication use post-goniotomy.
• To determine the long-term success rate and complication profile of goniotomy in this population.

Main Methods:

• Retrospective, multicenter case series.
• Included fifteen eyes from ten children with pediatric non-infectious uveitis and glaucoma.
• Primary outcomes: postoperative IOP, number of IOP-lowering medications, and success rate (6 ≤ IOP ≤ 21 mmHg without major complications or re-interventions).

Main Results:

• Median IOP decreased significantly from 30 mmHg preoperatively to 15 mmHg at 5 years postoperatively (p < 0.001).
• The number of IOP-lowering medications reduced from a median of 4 to 0 at 5 years.
• Success rates were 100% at 1 year, 93% at 2 years, and 80% at 5 years, with no major complications.

Conclusions:

• Goniotomy is an effective and safe surgical option for managing uveitic glaucoma in children.
• The procedure demonstrates sustained IOP control and reduced medication dependence.
• Goniotomy offers a viable alternative to traditional surgeries with a favorable safety profile in the era of biologic therapies.