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. 2011 Jan;59 Suppl(Suppl1):S148-57.
doi: 10.4103/0301-4738.73683.

Update on congenital glaucoma

Anil K Mandal  1 , Debasis Chakrabarti
Affiliations

Update on congenital glaucoma

Anil K Mandal et al. Indian J Ophthalmol. 2011 Jan.

Abstract

Congenital glaucoma is a global problem and poses a diagnostic and therapeutic challenge to the ophthalmologist. A detailed evaluation under general anesthesia is advisable to establish the diagnosis and plan for management. Medical therapy has a limited role and surgery remains the primary therapeutic modality. While goniotomy or trabeculotomy ab externo is valuable in the management of congenital glaucoma, primary combined trabeculotomy-trabeculectomy offers the best hope of success in advanced cases. Trabeculectomy with antifibrotic agent and glaucoma drainage devices has a role in the management of refractory cases, and cyclodestructive procedures should be reserved for patients where these procedures have failed. Early diagnosis, prompt therapeutic intervention and proper refractive correction are keys to success. Management of residual vision and visual rehabilitation should be an integral part of the management of children with low vision and lifelong follow-up is a must.

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Conflict of interest statement

Conflict of Interest: None declared.

Figures

Figure 1
Figure 1
Primary congenital glaucoma
Figure 2
Figure 2
Anatomy of the limbal region identified and Schlemm’s canal is explored
Figure 3
Figure 3
Trabeculotomy probe rotated into AC from the left side
Figure 4
Figure 4
Trabeculotomy probe rotated into AC from the right side
Figure 5
Figure 5
The deeper trabecular block is removed
Figure 6
Figure 6
Closure of the conjunctival incision with 8-0 vicryl
Figure 7
Figure 7
Primary congenital glaucoma operated at the age of 1 week
Figure 8
Figure 8
Three years postoperative appearance of the same child with normal vision
Figure 9
Figure 9
Long-term success after combined trabeculotomy– trabeculectomy
Figure 10
Figure 10
Anterior segment photograph after failed primary surgery
Figure 11
Figure 11
Anterior segment photograph showing bleb appearance after mitomycin-C augmented trabeculectomy
See this image and copyright information in PMC

Comment in

References

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MeSH terms