Outcome of surgical treatment of primary and secondary glaucoma in young children

PurposeTo describe a paediatric cohort surgically treated for primary or secondary glaucoma (PG/SG), with regard to incidences, visual outcome and control of intraocular pressure (IOP). MethodsAll children (n=29, 42 eyes in total) surgically treated for PG or SG at the age of 4years or younger between January 2002 and December 2010 at Sahlgrenska University Hospital in Molndal were retrospectively studied through medical records. Median follow-up time after initial surgery was 5.9years (range 2.4-11.2years). ResultsThe incidence of primary congenital glaucoma was 4.3 cases per 100000 live births in the county of Vastra Gotaland. For glaucoma secondary to cataract surgery, the incidence was 13% with a median postoperative duration to diagnosis of glaucoma of 3.8months (range 1.6months to 4.3years). Preoperative mean IOP was 31.5 (SD 8.1) mmHg, and mean IOP at last visit was 17.1 (SD 4.4) mmHg. For the entire cohort, 30% of the glaucoma eyes required more than two IOP-lowering surgical procedures during the study period. BCVA was 0.3 (decimal) in 45% of glaucomatous eyes at last follow-up with no statistically significant difference between PG and SG. Analysis of functional visual outcome, that is BCVA in the better eye, showed that 83% of all patients attained a BCVA of 0.5. ConclusionsThe incidences and outcome of surgically treated paediatric glaucoma were in accordance with previous studies. Chamber angle surgery, and if necessary, tube implantation without the use of antimetabolites, is a favourable approach leaving most sites needed for future glaucoma surgery unaffected.