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Surgical Management of Primary Congenital Glaucoma: Results of a Nationwide Descriptive Study in France (CONGLAU)

Jean-François Rouland1, Adèle Mekerke1, Florent Aptel2,3

  • 1Department of Ophthalmology, Hôpital Claude Huriez, Lille University Hospital, Lille, 59037, France.

Clinical Ophthalmology (Auckland, N.Z.)
|September 11, 2025
PubMed

Insights

Surgical practices for primary congenital glaucoma (PCG) in France show angle-based surgeries like trabeculotomy are effective. Mitomycin C (MMC) may not be essential for first-line PCG treatment, potentially improving outcomes.

Area of Science:

  • Ophthalmology
  • Pediatric Surgery
  • Glaucoma Research

Background:

  • Childhood glaucoma, specifically primary congenital glaucoma (PCG), is a rare yet severe condition.
  • There is no universally recognized standard surgical procedure for PCG, leading to varied surgical practices.
  • Understanding current surgical approaches is crucial for improving treatment strategies in young patients.

Purpose of the Study:

  • To describe and analyze surgical practices for primary congenital glaucoma (PCG) in France.
  • To evaluate the effectiveness of different surgical procedures and the use of antimitotic agents in PCG.
  • To identify trends in surgical success rates and the need for secondary interventions.

Main Methods:

  • A retrospective, observational, multicenter study involving 83 patients (<4 years) with PCG across 16 French reference centers (2013-2018).
  • Data collected included intraocular pressure (IOP) at baseline, 1 month, and 1 year post-surgery, initial surgical procedure, use of mitomycin C (MMC), secondary interventions, and surgical success.
  • Surgical success was categorized as complete, relative, or failure.

Main Results:

  • Trabeculotomy (31.0%) and trabeculotomy/trabeculectomy (20.7%) were the most common initial surgeries.
  • Median IOP reductions were observed at 1 month and 1 year, with trabeculectomy showing the largest reduction at 1 year (-55%).
  • Overall complete and relative surgical success rates were 21.5% and 33.6%, respectively. Mitomycin C use was associated with lower success rates (3.6% complete success) and more secondary interventions.

Conclusions:

  • Angle-based surgeries, such as trabeculotomy, showed a trend towards better effectiveness in PCG treatment.
  • The findings suggest that mitomycin C (MMC) may not be essential for first-line surgical management of PCG.
  • Further research into standardized surgical approaches and the role of adjunctive medications is warranted.
Abstract

Keywords:
childhoodglaucomaobservationalprimarysurgery

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