Aim: To evaluate the long-term outcomes of surgical treatment in unilateral primary congenital glaucoma (PCG), with a focus on stabilizing intraocular pressure (IOP) and structural and functional parameters of the affected eye.
Material and methods: A retrospective analysis was performed on 20 eyes of 20 patients with unilateral PCG operated on between 2002-2022 by combined trabeculotomy-trabeculectomy (CTT) or trabeculectomy (TBE) with/without MMC at the Department of Pediatric Ophthalmology, University Hospital Brno. The evaluated parameters included age at the time of diagnosis and surgery, type and number of procedures, pre- and postoperative IOP, presence of buphthalmos and Haab's striae, corneal diameter, cup-to-disc ratio (C/D), spherical equivalent (SE), best-corrected visual acuity (BCVA), use of medication, visual field findings, and retinal nerve fiber layer (RNFL) thickness on OCT. Surgical success was defined as IOP ≤ 21 mmHg without the need for further glaucoma surgery.
Results: Mean age at the time of diagnosis was 7.9 months, with 85% diagnosed before 6 months; mean period of follow-up monitoring was 12.3 years. CTT was performed in 55% and TBE in 45% of patients, with mean age at the time of surgery of 10 months. All eyes presented with buphthalmos and Haab's striae; mean corneal diameter was 13.1 mm. The C/D ratio decreased from 0.53 to 0.26 (p = 0.002) and IOP from 30.1 to 14.7 mmHg (p.
Keywords: combined trabeculotomy with trabeculectomy (CTT); reversal of glaucomatous cupping; unilateral primary congenital glaucoma.