Résultats pressionnels et visuels à long terme de la sclérectomie profonde dans le glaucome congénital primitif

Can J Ophthalmol. 2017 Apr;52(2):207-213. doi: 10.1016/j.jcjo.2016.09.008. Epub 2017 Jan 10.

Abstract

Objective: To estimate long term future of pressure and vision of children who underwent DS for CPG.

Material and methods: Children affected by CPG, aged from 1 day to 3 years at the time of the diagnosis were retrospectively included between 1999 and 2014. All benefited from a DS with use of antimetabolites. Preoperative and long-term post-operative intraocular pressures (IOP), per and postoperative complications as well as visual acuity and refractive status were estimated. Complete IOP control was defined by a postoperative IOP ≤16 mmHg without medical treatment.

Results: 141 eyes of 71 children were included (sex ratio: 1.02). Mean follow-up was 56.6 ±9.6 months. Final average IOP among the whole sample was 11.3 +/-7 mmHg. The rate of total success was 69.4 %, partial success 27.6 % and 3 % failure at the last check. No complications were seen in 85.1 % of cases (n=120 eyes). Among 37 children analyzed for visual acuity, maintained visual acuity was found in 50 % of cases (n= 37 eyes).

Conclusion: DS allows obtaining good IOP control with a very low rate of complications, and should be considered as a technique of choice in the surgical management of CPG. This study is of particular relevance because it has been led on a long term period and on an important staff considering the rare prevalence of the condition.

MeSH terms

  • Child, Preschool
  • Female
  • Follow-Up Studies
  • France / epidemiology
  • Glaucoma / physiopathology
  • Glaucoma / surgery*
  • Humans
  • Incidence
  • Infant
  • Infant, Newborn
  • Intraocular Pressure / physiology*
  • Male
  • Postoperative Complications / epidemiology
  • Refraction, Ocular / physiology*
  • Retrospective Studies
  • Time Factors
  • Trabeculectomy / methods*
  • Treatment Outcome
  • Visual Acuity*