ISSN: 1300-0365
Dil: Türkçe
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Our Management Of Pediatric Glaucoma Patients
Murat DOĞRU*, Haluk ERTÜRK**, Ahmet ÖZMEN***, Berkant KADERLİ****
* Yrd.Doç.Dr., Uludağ Üniversitesi Göz Hastalıkları AD,** Prof.Dr., Uludağ Üniversitesi Göz Hastalıkları AD,*** Doç.Dr., Uludağ Üniversitesi Göz Hastalıkları AD,**** Araş.Gör.Dr., Uludağ Üniversitesi Göz Hastalıkları AD, BURSA
Purpose: To investigate the results attained following surgery for pediatric glaucoma and to delineate the important aspects of patient management in such cases. Material and Method: The records of the 28 eyes of 20 patients who received surgery for primary congenital or secondary glaucoma between January 1990 and September 2000 were retrospectively reviewed. Sex, age, associated systemic diseases, pre and postoperative visual acuities, intraocular pressures (IOP) measured with applanation tonometry, slit lamp findings, corneal diameters (CD), cup/disc (C/D) changes, antiglaucomatous medications, surgical procedures, age at surgery and the postoperative complications were recorded. Goniotomy, trabeculectomy with or without an antimetabolite agent were employed as primary procedures, whereas Ahmed valve implantation or trabeculectomy with an antimetabolite were done as secondary procedures when necessary. Cases with no photophobia and epiphora, an IOP reading of less than 21 mmHg, a stable or a C/D regression of more than 0.2 were regarded as successful. Fisher test was used for statistical analyses.Results: In congenital glaucoma cases, the initial examination revealed a mean IOP of 30.1±10.3 mmHg, whereas the final examination showed a mean reading of 12.7±4.5 mmHg. In secondary glaucoma cases, these values were 34±7.3mmHg and 16.2±11.2mmHg respectively. The mean preoperative C/D was 0.4±0.1 and 0.35±0.1 at the last follow up examination for congenital glaucoma cases. These values were 0.42±0.26 and 0.58±0.24 respectively in patients with secondary glaucoma. There were no significant pre and postoperative differences in the CD measurements for both groups. The most common postoperative complications were pupillary irregularity followed by cystic bleb.Conclusion: Successful results may be attained with trabeculectomy as primary surgery for congenital glaucoma. Primary trabeculectomy may also be helpful in secondary glaucoma cases without angle anomalies, systemic complications or anterior segment inflammation. Satisfactory results can be achieved after trabeculectomy with antimetabolites or Ahmed valve implantation in refractory cases. Visually rewarding results can be obtained in cases who received keen refraction and occlusion therapy.Keywords: Congenital glaucoma, Secondary glaucoma, Goniotomy, Trabeculotomy, TrabeculectomyT Klin J Ophthalmol 2002, 11:182-188Turkiye Klinikleri J Ophthalmol 2002, 11:182-188
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