Abstract
Aim: To determine the long-term surgical outcomes of a cohort of complex patients with primary congenital glaucoma, aniridia and anterior segment dysgenesis.
Methods: Retrospective consecutive series between 1990-2021 in two UK tertiary centres: Guy’s and St Thomas’ NHS Foundation Trust and King’s College Hospital NHS Foundation Trust. We recorded the number and types of surgical and laser treatments along with preoperative and postoperative data, including intraocular pressures (IOP) and anti-glaucoma medications.
Results: A total of 41 eyes of 21 patients were included. Primary diagnoses were primary congenital glaucoma in 16 eyes (39.0%), aniridia in 14 eyes (34.2%), and anterior segment dysgenesis in 8 eyes (19.5%). Sixteen eyes (39.0%) had one or more glaucoma surgery or laser procedures for advanced glaucoma, and the long-term follow-up was 12.8 ± 3.6 years. At the last clinic visit, mean IOP was significantly decreased from 28.3 ± 3.7 preoperatively to 15.5 ± 1.7 mmHg postoperatively (p = 0.0027). Seven of the 16 eyes (43.7%) with advanced glaucoma also maintained well-controlled IOPs and did not require any anti-glaucoma medications. Four eyes (25.0%) had postoperative complications (hyphaema, hypotony) that resolved after conservative management. No patients lost vision because of surgery or laser treatment in these complex eyes.
Conclusions: Surgical management of these complex eyes with advanced glaucoma is challenging. Overall, the cohort had good surgical outcomes with a significant decrease in IOP by 45.2% and about half of the patients remaining off anti-glaucoma medications after long-term follow-up.
Methods: Retrospective consecutive series between 1990-2021 in two UK tertiary centres: Guy’s and St Thomas’ NHS Foundation Trust and King’s College Hospital NHS Foundation Trust. We recorded the number and types of surgical and laser treatments along with preoperative and postoperative data, including intraocular pressures (IOP) and anti-glaucoma medications.
Results: A total of 41 eyes of 21 patients were included. Primary diagnoses were primary congenital glaucoma in 16 eyes (39.0%), aniridia in 14 eyes (34.2%), and anterior segment dysgenesis in 8 eyes (19.5%). Sixteen eyes (39.0%) had one or more glaucoma surgery or laser procedures for advanced glaucoma, and the long-term follow-up was 12.8 ± 3.6 years. At the last clinic visit, mean IOP was significantly decreased from 28.3 ± 3.7 preoperatively to 15.5 ± 1.7 mmHg postoperatively (p = 0.0027). Seven of the 16 eyes (43.7%) with advanced glaucoma also maintained well-controlled IOPs and did not require any anti-glaucoma medications. Four eyes (25.0%) had postoperative complications (hyphaema, hypotony) that resolved after conservative management. No patients lost vision because of surgery or laser treatment in these complex eyes.
Conclusions: Surgical management of these complex eyes with advanced glaucoma is challenging. Overall, the cohort had good surgical outcomes with a significant decrease in IOP by 45.2% and about half of the patients remaining off anti-glaucoma medications after long-term follow-up.
| Original language | English |
|---|---|
| Journal | European Journal of Ophthalmology |
| Publication status | Accepted/In press - 22 Dec 2021 |