Surgical results of secondary glaucomas in childhood.
OBJECTIVE
This study aimed to describe results of glaucoma surgeries performed at one institution over the past 20 years in children with aphakia, aniridia, anterior segment dysgenesis, and other secondary glaucomas.


METHODS
The study design was a retrospective review.


METHODS
Fifty-eight eyes of 40 patients were studied.


METHODS
Trabeculectomy with or without mitomycin C, Molteno implantation, goniotomy, sclerostomy, endolaser cyclophotocoagulation, and cyclocryotherapy were performed.


METHODS
Intraocular pressure (IOP) control, defined as complete success (IOP < or = 21 without medications) or qualified success (IOP < or = 25 without medications or IOP < or = 21 with medications) and postoperative visual acuity stability were assessed.


RESULTS
One hundred thirty surgical procedures were performed on 58 eyes of 40 patients; follow-up averaged 7.3 years. Intraocular pressure control was achieved in 40 (70%) of 57 eyes after 1 or more procedures. Intraocular pressure control and stabilization of visual acuity and optic disc appearance were achieved in 28 (51%) of 55 eyes. Five eyes had significant postoperative complications. Trabeculectomy with mitomycin C controlled IOP on last visit in 8 of 13 eyes with aphakic glaucoma.


CONCLUSIONS
Surgical intervention can control IOP and prevent visual loss in children with secondary glaucomas. In the authors' experience, a filtering procedure is the most effective treatment in aphakic glaucoma and anterior segment dysgenesis.
Wallace
D K
DK
Department of Ophthalmology, University of North Carolina at Chapel Hill, USA.
Plager
D A
DA
Snyder
S K
SK
Raiesdana
A
A
Helveston
E M
EM
Ellis
F D
FD
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D002924:Ciliary Body / Q000601:surgery; D017679:Cryotherapy; D005124:Eye Abnormalities / Q000150:complications; D005500:Follow-Up Studies; D005901:Glaucoma / Q000209:etiology* / Q000503:physiopathology / Q000601:surgery*; D006068:Gonioscopy; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007429:Intraocular Pressure / Q000502:physiology; D017075:Laser Coagulation; D016685:Mitomycin / Q000008:administration & dosage; D018465:Molteno Implants; D013508:Ophthalmologic Surgical Procedures; D012189:Retrospective Studies; D012599:Sclerostomy; D014130:Trabeculectomy; D016896:Treatment Outcome; D014792:Visual Acuity / Q000502:physiology
D016685:Mitomycin