Long-term success after trabeculotomy in primary congenital glaucoma – a study with up to 35 years follow-up
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Long-term success after trabeculotomy in primary congenital glaucoma – a study with up to 35 years follow-up. / Kessel, Line; Pedersen, Karen Bjerg; Siersma, Volkert; Kappelgaard, Per; Bach-Holm, Daniella.
I: Acta Ophthalmologica, Bind 99, Nr. 4, 2021, s. 362-368.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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T1 - Long-term success after trabeculotomy in primary congenital glaucoma – a study with up to 35 years follow-up
AU - Kessel, Line
AU - Pedersen, Karen Bjerg
AU - Siersma, Volkert
AU - Kappelgaard, Per
AU - Bach-Holm, Daniella
PY - 2021
Y1 - 2021
N2 - Purpose: To evaluate the surgical success after trabeculotomy for primary congenital glaucoma (PCG) in Denmark in the last 40 years. Methods: Retrospective review of medical files on children who all underwent trabeculotomy as the first surgical intervention between January 1rst, 1977 and December 31, 2016. Information on diagnosis and surgical procedures were extracted. Primary outcome was surgical success was defined as intraocular pressure (IOP) < 21 mmHg without medications one year after surgery. Secondary outcome was the number of reoperations needed. Results: Out of 118 children with PCG, 96 children (144 eyes) had an ab externo trabeculotomy as primary IOP lowering procedure opening Schlemm’s channel 4 clock hours into the anterior chamber. Complete surgical success at one year was achieved in 73% (106 of 144 eyes). On the long term, IOP could be controlled by one surgical procedure in 2/3 of children, eight eyes required >5 surgical procedures to control IOP. In 12.1% of children the second glaucoma procedure was performed >5 years after the initial trabeculotomy. There was a tendency towards greater risk of needing a second procedure in patients < 3 months of age at primary trabeculotomy (hazard ratio, HR, 2.01, 95% CI 0.96–4.22) and in boys (HR 2.02, 95% CI 0.97–4.18) and a lower risk of requiring a third surgery if the second surgery was trabeculectomy with MMC. Conclusion: Dedicated follow-up of patients with PCG is essential as the disease may continue to progress even after years of quiescence and some children need multiple surgeries to control IOP. Additional glaucoma procedures are required in 1/3 of children and boys and younger patients seem to be at greater risk.
AB - Purpose: To evaluate the surgical success after trabeculotomy for primary congenital glaucoma (PCG) in Denmark in the last 40 years. Methods: Retrospective review of medical files on children who all underwent trabeculotomy as the first surgical intervention between January 1rst, 1977 and December 31, 2016. Information on diagnosis and surgical procedures were extracted. Primary outcome was surgical success was defined as intraocular pressure (IOP) < 21 mmHg without medications one year after surgery. Secondary outcome was the number of reoperations needed. Results: Out of 118 children with PCG, 96 children (144 eyes) had an ab externo trabeculotomy as primary IOP lowering procedure opening Schlemm’s channel 4 clock hours into the anterior chamber. Complete surgical success at one year was achieved in 73% (106 of 144 eyes). On the long term, IOP could be controlled by one surgical procedure in 2/3 of children, eight eyes required >5 surgical procedures to control IOP. In 12.1% of children the second glaucoma procedure was performed >5 years after the initial trabeculotomy. There was a tendency towards greater risk of needing a second procedure in patients < 3 months of age at primary trabeculotomy (hazard ratio, HR, 2.01, 95% CI 0.96–4.22) and in boys (HR 2.02, 95% CI 0.97–4.18) and a lower risk of requiring a third surgery if the second surgery was trabeculectomy with MMC. Conclusion: Dedicated follow-up of patients with PCG is essential as the disease may continue to progress even after years of quiescence and some children need multiple surgeries to control IOP. Additional glaucoma procedures are required in 1/3 of children and boys and younger patients seem to be at greater risk.
KW - primary congenital glaucoma
KW - surgical success
KW - trabeculectomy
KW - trabeculotomy
U2 - 10.1111/aos.14619
DO - 10.1111/aos.14619
M3 - Journal article
C2 - 32914564
AN - SCOPUS:85090796463
VL - 99
SP - 362
EP - 368
JO - Acta Ophthalmologica
JF - Acta Ophthalmologica
SN - 1755-375X
IS - 4
ER -
ID: 249056539