Surgical management of primary congenital glaucoma in egypt

Purpose To study primary congenital glaucoma characteristics and surgery in a University-based practice in Egypt. Patients and methods The present study was a retrospective chart review of 165 eyes of 112 children who presented and were operated upon between 2005 and 2012 at Alexandria Main Univer...

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Main Author: Nader H.L. Bayoumi
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2016-01-01
Series:Journal of the Egyptian Ophthalmological Society
Subjects:
Online Access:http://www.jeos.eg.net/article.asp?issn=2090-0686;year=2016;volume=109;issue=2;spage=85;epage=92;aulast=Bayoumi
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author Nader H.L. Bayoumi
author_facet Nader H.L. Bayoumi
author_sort Nader H.L. Bayoumi
collection DOAJ
description Purpose To study primary congenital glaucoma characteristics and surgery in a University-based practice in Egypt. Patients and methods The present study was a retrospective chart review of 165 eyes of 112 children who presented and were operated upon between 2005 and 2012 at Alexandria Main University Hospital in Egypt. The charts were reviewed for demographics as well as clinical data. Postoperative data were retrieved till the end of the follow-up period. Complications were noted, and success rates were studied. Results The mean age±SD (range) of the study population at presentation was 6.1±4.4 (1–24) months, and of the follow-up period was 32.3±21.7 (6–78) months. The average (range) number of glaucoma procedures performed for each eye was 1.3 (1–4). The most common primary glaucoma surgical procedure performed was combined trabeculotomy–trabeculectomy with mitomycin C (143 procedures). The mean values (range) of preoperative intraocular pressure (on no intraocular pressure lowering therapy), corneal diameter and thickness, cup/disc ratio and axial length of the study eyes were 18.7±5.9 (5–36) mmHg, 12.8±0.9 (10–17) mm and 619.5±95.2 (433–784) μm, 0.6±0.2 (0–1) and 22.99±1.82 (17.0–30.59) mm, respectively, and postoperatively at last follow-up were 7.4±6.6 (0–46) mmHg, 13.0±0.9 (10–18) mm and 530.6±75.1 (425–823) μm, 0.3±0.3 (0–1) and 24.06±2.13 (20.55–30.75) mm, respectively. Cumulative success by Kaplan–Meier analysis was 0.97, 0.89, 0.83, 0.73 and 0.61 at 1, 2, 3, 4 and 5 years, respectively. Complications included corneal scarring, cataract, intraretinal haemorrhages, hypotony disc oedema, rhegmatogenous retinal detachment and endophthalmitis. Conclusion Combined trabeculotomy–trabeculectomy with mitomycin C is a successful treatment for primary congenital glaucoma. Meticulous, continuous and prolonged follow-up is mandatory for all operated cases to ensure long-term success.
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spelling doaj.art-9c5ae1a987474337bf2788ee980dee232022-12-22T00:44:18ZengWolters Kluwer Medknow PublicationsJournal of the Egyptian Ophthalmological Society2090-06862314-66482016-01-011092859210.4103/2090-0686.193398Surgical management of primary congenital glaucoma in egyptNader H.L. BayoumiPurpose To study primary congenital glaucoma characteristics and surgery in a University-based practice in Egypt. Patients and methods The present study was a retrospective chart review of 165 eyes of 112 children who presented and were operated upon between 2005 and 2012 at Alexandria Main University Hospital in Egypt. The charts were reviewed for demographics as well as clinical data. Postoperative data were retrieved till the end of the follow-up period. Complications were noted, and success rates were studied. Results The mean age±SD (range) of the study population at presentation was 6.1±4.4 (1–24) months, and of the follow-up period was 32.3±21.7 (6–78) months. The average (range) number of glaucoma procedures performed for each eye was 1.3 (1–4). The most common primary glaucoma surgical procedure performed was combined trabeculotomy–trabeculectomy with mitomycin C (143 procedures). The mean values (range) of preoperative intraocular pressure (on no intraocular pressure lowering therapy), corneal diameter and thickness, cup/disc ratio and axial length of the study eyes were 18.7±5.9 (5–36) mmHg, 12.8±0.9 (10–17) mm and 619.5±95.2 (433–784) μm, 0.6±0.2 (0–1) and 22.99±1.82 (17.0–30.59) mm, respectively, and postoperatively at last follow-up were 7.4±6.6 (0–46) mmHg, 13.0±0.9 (10–18) mm and 530.6±75.1 (425–823) μm, 0.3±0.3 (0–1) and 24.06±2.13 (20.55–30.75) mm, respectively. Cumulative success by Kaplan–Meier analysis was 0.97, 0.89, 0.83, 0.73 and 0.61 at 1, 2, 3, 4 and 5 years, respectively. Complications included corneal scarring, cataract, intraretinal haemorrhages, hypotony disc oedema, rhegmatogenous retinal detachment and endophthalmitis. Conclusion Combined trabeculotomy–trabeculectomy with mitomycin C is a successful treatment for primary congenital glaucoma. Meticulous, continuous and prolonged follow-up is mandatory for all operated cases to ensure long-term success.http://www.jeos.eg.net/article.asp?issn=2090-0686;year=2016;volume=109;issue=2;spage=85;epage=92;aulast=Bayoumicombined trabeculectomycongenitalglaucomaprimarytrabeculotomy
spellingShingle Nader H.L. Bayoumi
Surgical management of primary congenital glaucoma in egypt
Journal of the Egyptian Ophthalmological Society
combined trabeculectomy
congenital
glaucoma
primary
trabeculotomy
title Surgical management of primary congenital glaucoma in egypt
title_full Surgical management of primary congenital glaucoma in egypt
title_fullStr Surgical management of primary congenital glaucoma in egypt
title_full_unstemmed Surgical management of primary congenital glaucoma in egypt
title_short Surgical management of primary congenital glaucoma in egypt
title_sort surgical management of primary congenital glaucoma in egypt
topic combined trabeculectomy
congenital
glaucoma
primary
trabeculotomy
url http://www.jeos.eg.net/article.asp?issn=2090-0686;year=2016;volume=109;issue=2;spage=85;epage=92;aulast=Bayoumi
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