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M. Feusier, S. Roy, A. Mermoud; Deep Sclerectomy With Trabeculectomy in Pediatric Glaucoma. Invest. Ophthalmol. Vis. Sci. 2008;49(13):4171.
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© ARVO (1962-2015); The Authors (2016-present)
To evaluate the efficacy and safety of a combined deep sclerectomy and trabeculectomy technique (penetrating deep sclerectomy) in the surgical treatment of paediatric glaucoma.
A primary combined deep sclerectomy and trabeculectomy was performed in 35 eyes of 28 children suffering from pediatric glaucoma between March 1997 and October 2006. Clinical outcome assessment included refractive errors, best corrected visual acuity (BCVA), corneal status and diameters, intraocular pressure (IOP), rates of surgical complications and success.
The mean follow-up was 3.5 ± 2.9 years, and the mean age before surgery was 3.6 ± 4.5 years. The mean preoperative IOP was 31.9 ± 11.5 mmHg. At final follow-up visits, the mean IOP was 13.3 ± 5.6 mmHg, (p<0.005). The final best corrected visual acuity, available for 14 patients, was 0.66 ± 0.36, and 8 patients (57.1%) achieved 0.5 (20/40) or better in their better eye. The mean refractive error (spherical equivalent) at final follow-up visits was +0.83 ± 5.4. Six patients (43%) were affected by myopia. The complete and qualified success rates based on cumulative survival curve after 9 years were 52.3% and 70.6%, respectively (p<0.05).
Combined deep sclerectomy and trabeculectomy is a surgical technique developed to control IOP in congenital glaucoma. The intermediate results are satisfactory and promising. Previous classic glaucoma surgeries performed before this new technique had less favourable results. The number of sight threatening complications is related to the severity of glaucoma and number of previous surgeries.
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