Childhood glaucoma is rare, yet it can pose dire, sight-threatening consequences for the youngest of patients. A new study found newborns and children with congenital and secondary glaucoma had high success rates long-term after undergoing surgery for the condition.
Specifically, 90% of all eyes reached target IOP with or without medication, allowing for additional surgeries.
The research team from Germany enrolled 79 eyes of 52 children between the ages of three weeks and about 15 years old. All children had either primary congenital or secondary glaucoma and underwent either conventional probe trabeculotomy, 360° catheter-assisted trabeculotomy, filtering or cyclodestructive surgery between 2015 and 2017.
The most popular initial surgery was probe trabeculotomy (63%) followed by 360° trabeculotomy (22%) and cyclodestructive treatment (10%). The authors noted that 360° trabeculotomy couldn’t be performed successfully in three cases and was changed intraoperatively to probe trabeculotomy due to anterior chamber dysgenesis.
At the approximate four-year follow-up, researchers found IOP was significantly reduced in both primary congenital (preoperative IOP: 27.8mm Hg vs. postoperative IOP: 14.2mm Hg) and secondary glaucoma (preoperative IOP: 29.2mm Hg vs. postoperative IOP: 16.6mm Hg).
Even though IOP lowering was about the same in both groups, secondary glaucoma patients underwent more glaucoma surgeries and revisions, and, in general, are more prone to complications related to the disease, the researchers said.
Considering first surgical outcomes, 360° catheter-assisted trabeculotomy generally had the highest success rates, while cyclodestructive procedures had the lowest outcome results.
Hoffmann EM, Aghayeva F, Schuster AK, et al. Results of childhood glaucoma surgery over a long-term period. Acta Ophthalmol. August 6, 2021. [Epub ahead of print].