Surgical Therapy Of Primary Childhood Glaucoma And Secondary Glaucoma After Congenital Cataract Surgery
Published 2024 - 42nd Congress of the ESCRS
Reference: PO489 | Type: Poster | DOI: 10.82333/z4sc-wd92
Authors: Nina Zelenayova* 1 , Marek Fichtl 2 , Lenka Cilečková 1 , Jiri Cendelin 1 , Martin Hlozanek 1
1University Hospital Motol,Praha,Czech Republic, 2General University Hospital,Praha,Czech Republic
Purpose
To compare results of paediatric patients who underwent surgery for primary congenital or infantile glaucoma and secondary glaucoma after congenital cataract surgery in tertiary paediatric ophthalmology department. These two groups were selected as two largest groups of paediatric patients indicated for glaucoma surgery in our department.
Setting
Department of Ophtalmology, 2nd Faculty of Medicine, Charles University in Prague and Motol University Hospital
Methods
Inclusion criteria were patients diagnosed with congenital or infantile glaucoma and patients who underwent surgery for congenital cataract in the first year of age, who were indicated for primary glaucoma surgery from January 2018 to September 2021. The follow up period since primary glaucoma surgery was 2 years.
All cataract surgeries were performed by the same technique - small corneal incision, extracapsular cataract extraction, anterior vitrectomy and iridectomy. Patients were examined under general anaesthesia before the surgery and regularly after the surgery.
The set was 16 eyes of 11 patients with primary glaucoma and 11 eyes of 9 patients with secondary glaucoma.
Results
The most common primary surgery in primary glaucoma was trabeculotomy combined with trabeculectomy. Fifty percent of eyes required reoperations due to decompensated IOP. The type of primary glaucoma surgery in cataract group was not specific with 5 different surgery techniques. Fifty-four percent of eyes required reoperation. The IOP at the time of diagnoses was significantly higher in primary glaucoma (median 40mmHg, SD ± 8.2 vs. median 28mmHg, SD ± 7.0). Visual acuity was significantly worse in the cataract group (median BCVA 0.05 vs. median BCVA 0.3), which is very likely due to significant amblyopia in children with congenital cataract.
Conclusions
In conclusion in these two groups of patients, no statistically significant difference was found in the number of eyes requiring reoperation after primary glaucoma surgery.