Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2005 Feb;89(2):165-8.
doi: 10.1136/bjo.2004.046037.

Augmented trabeculectomy in paediatric glaucoma

R Ehrlich  1 , M Snir, M Lusky, D Weinberger, R Friling, D D Gaton
Affiliations

Augmented trabeculectomy in paediatric glaucoma

R Ehrlich et al. Br J Ophthalmol. 2005 Feb.

Abstract

Aims: To report the experience with trabeculectomy augmented with mitomycin C and 5-fluorouracil for the treatment of paediatric glaucoma.

Methods: Retrospective, interventional case series design was used. The sample included 17 children (29 eyes) with primary (19 eyes) or secondary (10 eyes) glaucoma who were treated with augmented trabeculectomy as the primary procedure between 1990 and 2002. Data were collected on age and family history, preoperative and end of follow up intraocular pressure, cup/disc ratio (evaluated by drawing), visual acuity, complications, and post-surgery treatment.

Results: Patient age at surgery ranged from 1 month to 8 years; most patients (n = 14, 82.3%) were aged less than 1 year (range 1 month-8 months, mean 3.95 (SD 2.56) months); three patients (17.7%) were aged 3, 5, and 8 years. The duration of follow up was 3-120 months (mean 46 months). Intraocular pressure significantly improved from 21 mm Hg to 60 mm Hg (mean 33.1 (10) mm Hg) before surgery to 6-26 mm Hg (mean 17.1 (6) mm Hg) after, (p <0.0001). There was no significant change in cup/disc ratio: 0.1-0.8 (mean 0.42 (0.26)) before and 0.1-1.0 (mean 0.511 (0.27)) after (p = 0.45). In 22 eyes (75.8%), intraocular pressure was controlled at less than 20 mm Hg and the cup/disc ratio remained stable or improved. The life table success rate for intraocular pressure control remained stable at 86% at the 12, 24, and 36 months and after 48 months decreased to 53%. There was no significant difference in the life table results between primary and secondary glaucoma. 14 eyes (48.2%) had a visual acuity better than 20/120 by the end of follow up. Repeated surgery was necessary in eight eyes (27.5%), and additional antiglaucoma treatment in 13 (44.8%). Complications included retinal detachment 1 year after surgery, choroidal detachment, and blebitis (one eye each).

Conclusions: Augmented trabeculectomy with mitomycin C and 5-fluorouracil may serve as the primary procedure in a selected group of paediatric patients with glaucoma.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Kaplan-Meier survival analysis for eyes with intraocular pressure <20 mm Hg.
Figure 2
Figure 2
Kaplan-Meier survival analysis for eyes with intraocular pressure <20 mm Hg. Comparison of patients with primary glaucoma and secondary glaucoma.
See this image and copyright information in PMC

References

    1. De Luise VP, Anderson DR. Primary infantile glaucoma. Surv Ophthalmol 1983;28:1–19. - PubMed
    1. Elder MJ. Combined trabeculotomy-trabeculectomy compared with primary trabeculectomy for congenital glaucoma. Br J Ophthalmol 1994;78:745–8. - PMC - PubMed
    1. Meyer G, Schwenn O, Pfeiffer N, et al. Trabeculotomy in congenital glaucoma. Graefes Arch Clin Exp Ophthalmol 2000;238:207–13. - PubMed
    1. Song J, Stinnett SS, Whitson JT, et al. Ten-year surgical experience with childhood glaucoma. J Pediatr Ophthalmol Strabismus 2003;40:11–18. - PubMed
    1. Snir M, Lusky M, Shalev B, et al. Mitomycin C and 5-fluorouracil antimetabolite therapy for pediatric glaucoma filtration surgery. Ophthalmic Surg Lasers 2000;31:31–7. - PubMed

MeSH terms