Long-term outcome of trabeculotomy for the treatment of developmental glaucoma

Arch Ophthalmol. 2004 Aug;122(8):1122-8. doi: 10.1001/archopht.122.8.1122.

Abstract

Objective: To elucidate long-term outcome of trabeculotomy in primary and secondary developmental glaucoma.

Methods: One hundred forty-nine eyes of 89 patients with developmental glaucoma who underwent trabeculotomy were retrospectively studied. Intraocular pressure (IOP), success probabilities, visual acuities, and visual field were determined during follow-up and at the final visit.

Results: The mean +/- SD IOP of 112 eyes with primary developmental glaucoma at the final visit with an mean +/- SD follow-up period of 9.5 +/- 7.1 years was 15.6 +/- 5.0 mm Hg. The average IOP for 37 eyes with secondary developmental glaucoma was 16.7 +/- 4.2 mm Hg. One hundred eyes (89.3%) with primary developmental glaucoma were defined as achieving success at the final visit. Complete and qualified successes were achieved in 71 eyes (63.4%) and 29 eyes (25.9%), respectively. Visual acuities were 20/40 or better in 78 (59.5%) of 131 eyes examined and were poorer than 20/200 in 32 eyes (24.4%). The causes of poor visual acuities were mainly progression of glaucoma, including delay of detection of onset or surgery and amblyopia. Eyes with glaucoma that existed before 2 months of age or eyes that needed several trabeculotomies were considered to have poor visual acuity. Visual fields were classified as normal or almost normal in 21 (44.7%) of 47 eyes.

Conclusions: Trabeculotomy for developmental glaucoma is effective over a long time. There is a fairly good prognosis for visual function of eyes with developmental glaucoma with early detection of the onset, proper treatment, and proper management after trabeculotomy.

MeSH terms

  • Adolescent
  • Anterior Chamber / abnormalities
  • Anterior Chamber / surgery*
  • Child
  • Child, Preschool
  • Female
  • Glaucoma / congenital*
  • Glaucoma / surgery*
  • Humans
  • Infant
  • Infant, Newborn
  • Intraocular Pressure
  • Intraoperative Complications
  • Life Tables
  • Longitudinal Studies
  • Male
  • Postoperative Complications
  • Probability
  • Retrospective Studies
  • Trabeculectomy / methods*
  • Treatment Outcome
  • Visual Acuity
  • Visual Fields