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A. Alsheikheh, H. Steffen, F. Grehn; Long–Term Results for Surgery in Unilateral Childhood Glaucoma . Invest. Ophthalmol. Vis. Sci. 2005;46(13):133.
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© ARVO (1962-2015); The Authors (2016-present)
Purpose:The aim of this study is to assess the functional results and morphological parameters in children surgically treated for unilateral glaucoma in comparison with the healthy fellow eyes. Methods: Data from 30 eyes and 15 patients who were operated on in our department between 1990 and 2002 were reviewed. This retrospective study only included eyes with unilateral primary congenital glaucoma (n=13), and with secondary glaucoma (n=2) in Sturge Weber syndrome. Cases with other causes for reduced visual acuity were excluded. We analysed the intraocular pressure (IOP), antero–posterior diameter of the eyeball, visual acuity, and refractive errors. Results: The age of patients at first manifestation was 5.4 ± 5.5 months (range 0 – 18.0 months). The mean period of follow–up was 55.9 ± 33.2 months (14.0 – 149.0). The mean number of surgical procedures performed on one eye was 2.0 ± 2.6 procedures (1.0 – 11.0). The mean IOP before first surgery was 31.8 ± 10.3 mmHg (17.0 – 51.0), and decreased to 14.9 ± 2.6 mmHg (11.0 – 20.0) at the last visit. 14 eyes (93.3%) did not need any further medical treatment after the last surgical procedure. At the first examination, the mean antero–posterior diameter of the glaucoma–eyeball measured 23.1 ± 2.1 mm [fellow eyes 20.7 ± 1.8mm (P=0.003)] and at the last visit 23.9 ± 1.7 mm [fellow eye 22.3 ± 1.4 mm (P=0.008)] respectively the best corrected visual acuity at the last visit in glaucoma eyes was 0.27 ± 5.3 lines [fellow eyes 0.74 ± 2.1 lines (P=0.007)]. Visual acuity was 20/60 or more in 7 glaucoma eyes (46.7%). Only in 13.3% of the glaucoma eyes visual acuity was less than 20/200. 50.0% of the glaucoma eyes presented with myopia, with a spherical equivalent of –7.1 ± 2.8 diopters, compared to 16.7% myopia in the fellow eyes with a spherical equivalent of –2.5 ± 1.8 diopters. Conclusions: Although a good long–term control of the IOP can often be achieved in childhood glaucoma and axial length growth can be halted significant differences remain between the glaucoma eyes and their fellow eyes in terms of visual acuity and the antero–posterior diameter of the eye.
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