title: Excision of Tenon Capsule in Pediatric Trabeculectomy: A Controlled Study.
abstract: OBJECTIVE
  To compare the results of trabeculectomy alone and combined with partial tenonectomy in pediatric glaucoma patients.
  
  
  METHODS
  This was a prospective, controlled, cohort study that included 64 eyes of 46 children younger than 12 years with uncontrolled glaucoma, who underwent trabeculectomy with mitomycin C in an institutional setting. Patients were randomized to undergo a trabeculectomy either with (group A) or without (group B) tenonectomy. Children were followed up prospectively for 24 months. Kaplan-Meier survival analysis and mean survival times with 95% confidence intervals (CIs) were calculated. Postoperative results were compared at 3, 6, 12, and 24 months of follow-up. The main outcome measures were: intraocular pressure (IOP), surgical success, postoperative interventions, and complications in both groups.
  
  
  RESULTS
  Mean postoperative IOP was lower in group A at all postoperative visits (19.2 mm Hg in group A vs. 22.1 mm Hg in group B at 24 mo, P=0.05). There was a tendency toward greater use of glaucoma medications in group B (P<0.001). Cumulative probability of survival at 24 months was 70% (95% CI, 48%-86%) for group A, and 45% (95% CI, 28%-63%) for group B (P=0.09). Mean survival time was significantly longer (P=0.04) in group A (16.6 mo) than in group B (11.6 mo). Encapsulation occurred more frequently (P=0.03) in group B (25%) than in group A (3%).
  
  
  CONCLUSIONS
  Excision of the Tenon capsule could help achieve better IOP control in pediatric glaucoma surgery.
authors: Department of Ophthalmology, Cairo University Faculty of Medicine, Cairo, Egypt.
authors: Ahmed
authors: A
authors: Awadein
authors: Yasmine M
authors: YM
authors: El Sayed
mesh_terms: D000477:Alkylating Agents / Q000008:administration & dosage; D002675:Child, Preschool; D005260:Female; D005901:Glaucoma / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D007223:Infant; D007429:Intraocular Pressure / Q000502:physiology; D008297:Male; D016685:Mitomycin / Q000008:administration & dosage; D010865:Pilot Projects; D011183:Postoperative Complications; D011446:Prospective Studies; D012086:Reoperation; D058475:Tenon Capsule / Q000601:surgery*; D014065:Tonometry, Ocular; D014130:Trabeculectomy / Q000379:methods*; D016896:Treatment Outcome; D014792:Visual Acuity / Q000502:physiology
chemical_list: D000477:Alkylating Agents; D016685:Mitomycin