Drainage devices recommended in newborn primary congenital glaucoma patients

Patients with newborn primary congenital glaucoma have a better chance of successful surgery if glaucoma drainage device implantations or trabeculectomies are performed instead of goniosurgery, according to the results of a study presented at the American Glaucoma Society annual meeting.

David Walton and colleagues from the Massachusetts Eye and Ear Infirmary, Harvard Medical School, USA performed a review of 42 patients who had newborn primary congenital glaucoma (19 boys and 23 girls). The diagnosis was made between 0 and three days in 95% of cases and the main diagnostic sign was bilaterally cloudy corneas (98%). Patients also usually presented with abnormally deep anterior chambers, abnormal irides and angles.

Dr Walton found that, although goniosurgery is successful in many glaucoma cases, it is only successful in around 8% of patients with newborn primary congenital glaucoma. In contrast, 25% of trabeculectomies and 65% of glaucoma drainage device procedures are successful.

Drainage devices do require careful monitoring in young children, however, Dr Walton believes the benefits outweigh the maintenance.