title: [Trabeculotomy as first-line surgical treatment in pediatric glaucoma: surgical and visual outcomes from a 7-year retrospective study].
abstract: BACKGROUND
  Intraocular pressure and visual outcomes in primary pediatric glaucoma treated with trabeculotomy.
  
  
  METHODS
  All children undergoing trabeculotomy as first-line surgical treatment between January 2002 and January 2012 were included in a retrospective monocentric study. We report initial clinical features, surgical complications, ophthalmological outcome and clinical progression.
  
  
  RESULTS
  Twenty-nine eyes of 16 children met the inclusion criteria and were treated with trabeculotomy as first-line treatment (mean age: 6 months). Median follow-up was 7 years. No major perioperative complications occurred, but minor complications were observed in 11 eyes. Mean pre-operative and initial post-operative intraocular pressures were 25.4 and 9.1mmHg respectively, thus a decrease of 16.3 points (63%). Overall surgical success rate was 89% at first follow-up, 72% at one year and 64% on last follow-up. A mean intraocular pressure of 15mmHg on no medications was achieved for two-thirds of eyes. After 7 years of follow-up, over 50% of eyes did not require a 2nd surgery. Visual acuity was at least 20/30 for 62% of eyes (83% for eyes requiring only trabeculotomy).
  
  
  CONCLUSIONS
  Trabeculotomy as first-line treatment of primary juvenile glaucoma is a safe and effective surgery in about two-thirds of cases. It allows pressure control and satisfactory visual outcome in the majority of children.
authors.affiliation: CHU de Nantes, 1, place Alexis-Ricordeau, 44093 Nantes cedex 1, France. Electronic address: elodiemartin85@hotmail.fr.
authors.forename: E
authors.initials: E
authors.lastname: Martin
authors.affiliation: CHU de Nantes, 1, place Alexis-Ricordeau, 44093 Nantes cedex 1, France.
authors.forename: G
authors.initials: G
authors.lastname: Le Meur
authors.affiliation: CHU de Nantes, 1, place Alexis-Ricordeau, 44093 Nantes cedex 1, France.
authors.forename: I
authors.initials: I
authors.lastname: Orignac
authors.affiliation: CHU de Nantes, 1, place Alexis-Ricordeau, 44093 Nantes cedex 1, France.
authors.forename: M
authors.initials: M
authors.lastname: Weber
authors.affiliation: CHU de Nantes, 1, place Alexis-Ricordeau, 44093 Nantes cedex 1, France.
authors.forename: P
authors.initials: P
authors.lastname: Lebranchu
authors.affiliation: CHU de Nantes, 1, place Alexis-Ricordeau, 44093 Nantes cedex 1, France.
authors.forename: A
authors.initials: A
authors.lastname: Péchereau
mesh_terms: D002648:Child; D002675:Child, Preschool; D005500:Follow-Up Studies; D005901:Glaucoma / Q000151:congenital* / Q000601:surgery*; D006801:Humans; D007223:Infant; D007429:Intraocular Pressure; D011183:Postoperative Complications; D012189:Retrospective Studies; D014130:Trabeculectomy; D014792:Visual Acuity
keywords: Chirurgie du glaucome; Congenital glaucoma; Glaucoma surgery; Glaucome congénital; Trabeculotomy; Trabéculotomie