[Trabeculectomy as the initial procedure in primary congenital glaucoma].
OBJECTIVE
To estimate the effectiveness of trabeculectomy performed in buphthalmic eyes.


METHODS
42 eyes of 24 children, 14 boys and 10 girls. There were 18 children (32 eyes) operated on at the age from 7 days to 12 months (group I) and 6 patients (10 eyes) at the age from 3 to 7 years (group II) with primary congenital glaucoma. Corneal diameter ranged from 11.5 to 15 mm in infants, in 10 eyes of 6 children elder than 2 years it was from 13 to 15 mm. The axial length of eyeballs was from 19 to 23.5 mm. Forty five trabeculectomies were performed, in 3 cases they were repeated two and six years after the first procedure. Follow up was from 1 year to 22 years, mean 82 months, 7 years of group I, 6 years of group II.


RESULTS
29 of 42 eyes (64.2%) with intraocular pressure varied between 8 and 21 mm Hg, other eyes required additional local antiglaucoma treatment. Normal IOP was obtained in 95.2% of eyes. Trabeculectomy normalized IOP in 68.9% eyes of infants (group I), whereas in elder children the percentage came up to 50 (group II). In other eyes pharmacological agents decreased IOL to values below 21 mm Hg, in the group I in 97% of eyes and in the group II in 90% of cases.


CONCLUSIONS
Trabeculectomy performed as a first procedure in primary congenital glaucoma is effective in infants and older children with buphthalmos in long-term follow-up. The necessity to perform this operation in very small children and even neonates does not always mean poor prognosis, and intraocular pressure can be stabilized at safe level for many years.
Koraszewska-Matuszewska
B
B
Z Kaedry i Kliniki Okulistyki Dzieciecej Slaskiej AM w Katowicach.
Samochowiec-Donocik
E
E
Pieczara
E
E
Lange
E
E
D000367:Age Factors; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D005901:Glaucoma / Q000151:congenital* / Q000601:surgery*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007429:Intraocular Pressure; D008297:Male; D011379:Prognosis; D014130:Trabeculectomy; D016896:Treatment Outcome