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Secondary intervention after failed initial intervention for primary congenital glaucoma

N Bayoumi1, E N Elsayed1

  • 1Department of Ophtalmology, Faculty of Medicine, Alexandria University, Alexandria, Egypt.

Journal Francais D'Ophtalmologie
|February 20, 2024
PubMed

Insights

Subsequent glaucoma surgeries are often needed for primary congenital glaucoma (PCG) cases that fail initial treatment. These repeat procedures demonstrate a success rate of approximately 70% in managing PCG.

Area of Science:

  • Ophthalmology
  • Pediatric Ophthalmology
  • Glaucoma Research

Background:

  • Primary congenital glaucoma (PCG) is a severe form of glaucoma presenting in infancy.
  • Initial surgical interventions for PCG can fail, necessitating further treatment.
  • Understanding outcomes of repeat surgeries is crucial for managing PCG.

Purpose of the Study:

  • To evaluate the effectiveness of subsequent surgical interventions in eyes with primary congenital glaucoma (PCG) that did not achieve success after the initial surgery.
  • To determine the success rates and long-term outcomes of repeat glaucoma surgeries in this pediatric population.

Main Methods:

  • A retrospective chart review was conducted on children diagnosed with PCG who underwent initial glaucoma surgery that failed.
  • Data collected included patient demographics and clinical characteristics before and after surgery.
  • Success was defined by intraocular pressure (IOP) below 16 mmHg, a reduction of IOP by at least 20%, and stable or improved optic nerve condition (cup-to-disc ratio).

Main Results:

  • Of 531 eyes with PCG, 58 eyes (10.9%) required repeat glaucoma surgery after initial failure.
  • The average number of glaucoma procedures per eye was 2.6.
  • Subsequent surgeries achieved success in approximately 70% of cases, based on established IOP and optic nerve criteria.

Conclusions:

  • Repeat glaucoma surgical procedures are necessary in a notable percentage of primary congenital glaucoma cases.
  • Subsequent surgeries offer a favorable success rate, around 70%, providing a viable option for managing persistent PCG.
  • These findings highlight the importance of considering repeat interventions for optimal long-term visual outcomes in PCG.
Abstract

Keywords:
AntimetaboliteAntimétaboliteGlaucome congénital primairePrimary congenital glaucomaReoperationRéopérationTrabeculotomyTrabeculotomy-trabeculectomyTrabéculotomieTrabéculotomie-trabéculectomie

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