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Related Experiment Videos

Trabeculectomy with adjunctive mitomycin C in pediatric glaucoma

A D Beck1, W R Wilson, M G Lynch

  • 1Department of Ophthalmology, Emory University School of Medicine, Atlanta, Georgia, USA. abeck@emory.edu

American Journal of Ophthalmology
|November 20, 1998
PubMed
Summary

Trabeculectomy with mitomycin C is effective for pediatric glaucoma, particularly in children over one year old. However, a significant risk of late-onset bleb-related endophthalmitis exists in this young patient group.

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Area of Science:

  • Ophthalmology
  • Pediatric Surgery
  • Glaucoma Management

Background:

  • Pediatric glaucoma requires effective surgical interventions.
  • Trabeculectomy augmented with mitomycin C is a common surgical approach.
  • Understanding risk factors for surgical failure is crucial in pediatric patients.

Purpose of the Study:

  • To evaluate the safety and efficacy of trabeculectomy with mitomycin C in patients aged 17 years or younger.
  • To identify specific risk factors associated with surgical failure in this pediatric population.

Main Methods:

  • Retrospective review of pediatric glaucoma cases undergoing mitomycin C-augmented trabeculectomy (1991-1995).
  • Analysis of 49 patients (60 eyes) with a mean age of 7.6 years.
  • Success defined by intraocular pressure ≤ 22 mm Hg, no progression, and no further surgery or devastating complications.

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Main Results:

  • Cumulative success rates were 67% at 12 months and 59% at 24 months.
  • Increased risk of failure was associated with age < 1 year (RR 5.6) and aphakia (RR 2.7).
  • Common complications included shallow anterior chamber and serous choroidal detachment; 8% developed bleb-related endophthalmitis.

Conclusions:

  • Trabeculectomy with mitomycin C demonstrates general effectiveness for pediatric glaucoma, especially in phakic children over one year old.
  • Late-onset bleb-related endophthalmitis represents a substantial risk in pediatric patients.
  • Risk factor identification aids in optimizing surgical outcomes for pediatric glaucoma.