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Bruno SAUTIERE, Alain DUHAMEL, Anne GALET, Jean-François ROULAND; Evolution Of Axial Length In Congenital Glaucoma. Invest. Ophthalmol. Vis. Sci. 2012;53(14):6766. doi: https://doi.org/.
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The aim of this study is to compare the evolution of axial length (AL) in the eyes with primary congenital glaucoma (CG) before and after surgery, and then to establish curves of growth for normal eyes versus those with CG.
It is a retrospective study of 25 children undergoing examination under general anesthesia for a suspicious CG in CHRU Lille (France) from October 2003 to September 2011. AL was measured with a contact biometer OCUSCAN (ALCON) and a 10 MHz probe. Other criterias were evaluated : intraocular pressure (IOP), examination of anterior segment, optic disc cup, measurement of corneal diameter and pachymetry, to determine the diagnosis. If the glaucoma progressed, a trabeculotomy was carried out. The statistical analysis was performed by an anova for repeated measurements using the linear mixed model.
50 eyes of 25 children were followed during 3 years +/- 28 months (mean +/- standard deviation). 22 patients presented a primary CG and it was bilateral in 14 cases. The diagnosis was made at an average of 7 months. A second surgery was performed in 7 eyes with a bad control of IOP at the age of 3.5 years approximately. AL evolution of healthy and CG eyes are both based on a quadratic curve. The growth of eyes with CG before trabeculotomy is accelerated compared to healthy eyes (p<0.0001), and reduced after one surgical success (p<0.0001). The curve becomes then slightly faster (p=0.04) to the normal eyes. There is no difference of AL evolution after the first surgery between the eyes with CG stabilized and that with a second surgery necessary (p=0.89); even if the eyes with two operations are longer.
The growth of AL slows down, when IOP is controlled by surgery in CG, and becomes almost parallel at the growth curve of normal eyes. The more glaucoma advanced a long time, the more eye will be long. Evolution of AL measurements is a useful parameter to diagnose and to follow the eyes suffering from CG, and can allow to make the distinction between glaucoma and "border line" eyes.
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