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A. Z. Soliman, T. C. Chen, D. S. Walton; Goniotomy Surgery for Late-Recognized Congenital Glaucoma. Invest. Ophthalmol. Vis. Sci. 2010;51(13):5276.
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To describe the results of goniotomy surgery for late-recognized congenital glaucoma.
We performed a retrospective review of patients older than 1 year of age who had goniotomy surgery from January 1978 to January 2009. Success was defined as a reduction of the intraocular pressure (IOP) to 22 mmHg or lower, following one or more goniotomy surgeries, with or without medications at the last follow-up visit, no additional glaucoma surgery, and no visually significant complications.
There were 26 eyes of 17 patients. Seven females (41.1%) and 10 males (58.8%). The mean age at the time of presentation was 5.5 ± 4.6 years.The mean age at the time of initial goniotomy surgery was 5.7 ± 4.7 years. The mean number of goniotomy surgeries was 2 ± 1.1. The mean IOP decreased from 36 ± 8.4 mm Hg to 17 ± 4.4 mm Hg at last follow-up. The average number of glaucoma medications used at last follow up was 0.96 ± 1.2. Only 3 of 17 patients (17.6%) required other types of glaucoma surgery to control the pressure. The mean postoperative follow-up period for all patients was 9.6 ± 7.9 years (range, 1.8 to 30.5 years). Cumulative probabilities of success were 100%, 88.5%, 76.9%, 68.8% and 68.8% at 1, 2, 3, 4 and 5 years, respectively. The most common post-operative event was hyphema. It occurred in 9 out of 26 eyes (34.6%). Most were minimal with only 3 of the 26 eyes (11.5%) showing hyphemas associated with transient IOPs greater than 40 mmHg.
Goniotomy surgery was found to be useful in the management of late-recognized congenital glaucoma. It should be considered when planning for the initial surgical procedure in late-recognized congenital glaucoma.
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