Abstract
Purpose :
The treatment of PCG is challenging for most ophthalmologists and there is a great difficulty in evaluating the benefits of early surgical outcome. Therefore, our purpose is to compare the surgical outcome in children with PCG with age ≤ 6 months and children with age > 6 months.
Methods :
A retrospective case series study was done in which data from patients with PCG who underwent trabeculotomy were collected at Hospital São Geraldo/HC-UFMG from 2002 to 2017. All trabeculotomies were performed by the same surgeon. After sedation of children, we measured, before and one month after surgery, the central corneal thickness (CCT), the IOP, the horizontal corneal diameter (HCD) and the axial length (AL).
Results :
A total of 17 patients (31 eyes) were included. The patients were divided into two groups: group 1 - diagnosis of PCG and first surgical intervention in children with age less than or equal to 6 months (17 eyes); group 2 - diagnosis of PCG and first surgical intervention in children over 6 months (14 eyes). The mean age in group 1 and group 2 was respectively 62.0±49.2 and 266±251 days (P=0.03). The mean pre-operative IOP in group 1 was 16.4±5.97 and 14.7±5.85 mmHg in group 2 (P= 0.46) and the postoperative IOP was 13.6±6.3 in group 1 and 9.14±6.11 mmHg in group 2 (P= 0.058). This last data may have suffered some influence from transient postoperative hypotony observed in two children from the group 2. A statistically significant difference was found between CCT (P= 0.005) in both groups but not in HCD (P=0.09). When it comes to the analysis of the AL, when updated to normal values of AL for each age (see table 1: Costa AMC, et al. IOVS 2005, 46: ARVO E-Abstract 671), it was shown in group 1 a mean of 0.2 ±1.25 mm above the superior normal limit while in group 2 the mean was of 2.60±1.12 mm, with a highly significant difference (P<0.001). Despite the higher mean IOP before surgery, the AL increase was lower in the group 1 after trabeculotomy, which suggests that an early trabeculotomy can provide a lower ocular growth as well as a better control of PCG.
Conclusions :
Early surgery is fundamental for an adequate IOP control and, consequently, for the lower ocular growth in children with PCG.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.