Effectiveness of ab externo trabeculectomy (AET) in the system of surgical treatment in infants with congenital glaucoma

Session Details

Session Title: Glaucoma I

Session Date/Time: Monday 07/09/2015 | 08:00-10:30

Paper Time: 09:14

Venue: Room 10

First Author: : T.Toykuliyev TURKMENISTAN

Co Author(s): :    T. Toykuliyev                    

Abstract Details

Purpose:

AET plays a significant role in the system of surgical treatment of congenital glaucoma. Among pathogenically oriented operations, AET is the least traumatical. Important part of this operation is correct localization of sinus, because schlemm canal often changes topography by moving backwards making it harder to detect in such patients. The purpose our research is to study the effectiveness of AET in infants congenital glaucoma.

Setting:

The clinical research was conducted in infants' department of the Scientific Clinical Center of Turkmenistan State Medical University,Ashgabat, Turkmenistan.

Methods:

Under our observation there were 33 patients (48 eyes with congenital glaucoma). 17 Infants of age up to 1 month, 12 of 2-6 months old, and 4 of 7-18 months old. Prior to operation the following observations were conducted: biomicroscopy, pneumatonometry, gonioscopy, and ophthalmoscopy. Observed infants' Intraocular Pressure (IOP) ranged 19-28, averaging 25.6 mm Hg. Glaucomatous excavation was found in 16 eyes and ranged from 0.3 to 0.5. More pronounced excavation (more than 0.5) was found in four cases in the age group of 6-18 month olds. AET operations were performed by using Harms Trabeculotom.

Results:

In 4 eyes during the operation, side cleavage of descemet membrane has occurred, which lead to development of keratopathy. On the 7th day after operation, IOP in 45 eyes was in the normal range and averaged 15 mm Hg. Only in 3 eyes IOP was 19-20 mm Hg. In long-term observation (from 1 to 36 months) 41 eyes' IOP has remained within normal range. In 2 eyes IOP was maintained in the range of 21-26 mm Hg by using hypotension drops. In 5 eyes repeated operation was performed with application of mitomycin, which has provided stable normalization of IOP.

Conclusions:

Our clinical observations has yielded that AET is an effective and pathogenicallly operation in the treatment of congenital glaucoma in infant. As a result of operation in 41 out of 48 operated eyes normalization of IOP was observed, which is very important for preserving the function of optic nerve. Observations has showed that operation in early age yields less recidive than operations performed at older age (12 month and older). Based on this, early stage detection and timely surgical treatment play a very important role for complete rehabilitation of congenital glaucoma in infants.

Financial Interest:

NONE