Medical and surgical aspects of congenital glaucoma.
During the years 1977-1986, 338 patients at the University Eye Clinic were diagnosed as having congenital glaucoma. This paper presents our experience of the management of 88 of these patients (161 eyes) who had a follow-up of at least 3 years. Medical therapy alone reduced the intraocular pressure to less than 21 mmHg in 17 eyes (11.8%) in the short-term and in 14 eyes (9.7%) in the long-term. Surgical intervention in 127 eyes (goniotomy: 9 eyes; trabeculotomy: 3 eyes; peripheral iridencleisis: 4 eyes; Elliott trephine; 23 eyes; trabeculectomy: 88 eyes), resulted in an immediate normalization of intraocular pressure in 98 eyes (77%, reducing to 66% at the final examination). Trabeculectomy normalized the intraocular pressure in 84% of eyes in the short-term and 76% in the long-term. Trabeculectomy is recommended as the surgical management of choice in congenital glaucoma in societies where presentation is late, or where individual surgeons may not be conversant with goniotomy.
D000086:Acetazolamide / Q000627:therapeutic use; D000322:Adrenergic Agonists / Q000627:therapeutic use; D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D017677:Age Distribution; D002648:Child; D002675:Child, Preschool; D004232:Diuretics / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D004837:Epinephrine / Q000627:therapeutic use; D005260:Female; D005500:Follow-Up Studies; D005901:Glaucoma / Q000151:congenital* / Q000628:therapy*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007429:Intraocular Pressure; D007498:Iris / Q000601:surgery; D008297:Male; D008916:Miotics / Q000627:therapeutic use; D010862:Pilocarpine / Q000627:therapeutic use; D013999:Timolol / Q000627:therapeutic use; D014130:Trabeculectomy
D000322:Adrenergic Agonists; D000319:Adrenergic beta-Antagonists; D004232:Diuretics; D008916:Miotics; D010862:Pilocarpine; D013999:Timolol; D000086:Acetazolamide; D004837:Epinephrine