Treating paediatric glaucoma

January 14, 2009

Penetrating deep sclerectomy (combining deep sclerectomy with trabeculectomy) delivers promising intermediate results in the treatment of paediatric glaucoma, according to the conclusions of a study published in the January issue of Ophthalmology.

Penetrating deep sclerectomy (combining deep sclerectomy with trabeculectomy) delivers promising intermediate results in the treatment of paediatric glaucoma, according to the conclusions of a study published in the January issue of Ophthalmology.

Sylvain Roy, MD, PhD of the Jules Gonin Eye Hospital at the University of Lausanne, Switzerland and colleagues conducted a retrospective non-interventional case series study of paediatric (mean preoperative age, 3.6±4.5 years) glaucoma patients (n=28; eyes, n=35) undergoing combined deep sclerectomy and trabeculectomy surgery between March 1997 and October 2006. Patients - who were examined preoperatively, and then postoperatively at day 1, day 7 and at 1, 2, 3, 4, 6, 9 and 12 months, and every six months thereafter - were assessed for intraocular pressure (IOP) change, a change in the number of medications prescribed, complications, and surgical revisions, among other factors. The mean follow-up was 3.5±2.9 years.

Preoperatively, mean IOP was 31.9±11.5 mmHg, which had decreased by 58.3% at the end of follow-up. Sight-threatening complications were more common for patients with refractory glaucomas; the number of these complications was also associated with the severity of the condition and the number of previous surgeries. At nine years postoperatively, the complete success rate was 52.3%; the qualified success rate at this point was 70.6%.

The team concluded that these intermediate results of combined deep sclerectomy and trabeculectomy are promising, and noted that these results are more favourable than earlier treatments trialled for this indication.