Treating paediatric glaucoma

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.