Skip to main content

Advertisement

SpringerLink
Log in

Factors affecting the surgical success of trabeculectomy performed as the first surgery in primary pediatric glaucoma

  • Original Paper
  • Published:
International Ophthalmology Aims and scope Submit manuscript

Abstract

Purpose

To present the outcomes and factors affecting the success of trabeculectomy performed as the first surgery in primary pediatric glaucoma.

Methods

Pediatric patients with primary glaucoma who underwent trabeculectomy as the first surgery were retrospectively reviewed. Age, gender, preoperative intraocular pressure (IOP), operation age, axial length, corneal diameter, anterior segment findings, antimetabolite used, complications, and 1-month, 3-months, 1-year, and most recent postoperative findings were recorded. Postoperative IOP with/without medication of 18 mmHg or less was considered successful. Factors that may have affected surgical success were also evaluated using multivariate analysis.

Results

Included in the study were 48 patients, of whom 30 had primary congenital glaucoma and 18 had juvenile glaucoma. The mean preoperative IOP was 36.84 ± 6.30 mmHg, and the mean follow-up time was 7.95 ± 6.93 years. The median operation age value was 100.00 ± 100.83 (median: 60; IQR: 153) months. The postoperative IOP at the 1-month, 3-months, 1-year, and most recent follow-ups were 15.39 ± 6.88, 15.70 ± 7.36, 16.28 ± 7.86, and 17.48 ± 8.44 mmHg, respectively (p = 0.565). While there were no postoperative complications in 24 of the patients (50.0%), the most common complications were choroidal detachment and hypotony. Postoperative complication development was found to be significant as a factor affecting surgical success in the multivariate logistic regression analysis. Surgical success rates for all of the patients were 71.7%, 65.9%, 65.0%, and 61.4% at the 1-month, 3-months, 1-year, and most recent follow-ups, respectively. A significant difference was found between the congenital and juvenile groups in terms of surgical success only at 3 months (p = 0.953, p = 0.042, p = 0.191, p = 0.218; respectively).

Discussion/Conclusion

The fact that surgical success was partially higher in the juvenile group confirmed the idea that the results of trabeculectomy will be more favorable in patients of older age and without anterior segment anomalies.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

Data availability

The manuscript has no associated data in a data repository.

References

  1. Aponte EP, Diehl N, Mohney BG (2010) Incidence and clinical characteristics of childhood glaucoma: a population-based study. Arch Ophthalmol 128:478–482

    Article  Google Scholar 

  2. Thau A, Lloyd M, Freedman S et al (2018) New classification system for pediatric glaucoma: implications for clinical care and a research registry. Curr Opin Ophthalmol 29:385–394

    Article  Google Scholar 

  3. Lambert SR, Purohit A, Superak HM et al (2013) Long-term risk of glaucoma after congenital cataract surgery. Am J Ophthalmol 156:355–361

    Article  Google Scholar 

  4. Gupta V, Somarajan BI, Gupta S et al (2017) The inheritance of juvenile onset primary open angle glaucoma. Clin Genet 92:134–142

    Article  CAS  Google Scholar 

  5. Yu Chan JY, Choy BN, Ng AL, Shum JW (2015) Review on the management of primary congenital glaucoma. J Curr Glaucoma Pract 9:92–99

    Article  Google Scholar 

  6. Chen TC, Chen PP, Francis BA et al (2014) Pediatric glaucoma surgery: a report by the American Academy of Ophthalmology. Ophthalmology 121:2107–2115

    Article  Google Scholar 

  7. Papadopoulos M, Edmunds B, Fenerty C, Khaw PT (2014) Childhood glaucoma surgery in the 21st century. Eye (Lond) 28:931–943

    Article  CAS  Google Scholar 

  8. Al-Obeidan SA, Eel-D O, Dewedar AS et al (2014) Efficacy and safety of deep sclerectomy in childhood glaucoma in Saudi Arabia. Acta Ophthalmol 92(1):65–70

    Article  Google Scholar 

  9. Elhofi A, Helaly HA (2020) Non-penetrating deep sclerectomy versus trabeculectomy in primary congenital glaucoma. Clin Ophthalmol 12(14):1277–1285

    Article  Google Scholar 

  10. Sturmer J, Broadway DC, Hitchings RA (1993) Young patient trabeculectomy. Assessment of risk factors for failure. Ophthalmology 100:928–939

    Article  CAS  Google Scholar 

  11. Fulcher T, Chan J, Lanigan B et al (1996) Long-term follow up of primary trabeculectomy for infantile glaucoma. Br J Ophthalmol 80:499–502

    Article  CAS  Google Scholar 

  12. Al-Hazmi A, Zwaan J, Awad A et al (1998) Effectiveness and complications of mitomycin C use during pediatric glaucoma surgery. Ophthalmology 105:1915–1920

    Article  CAS  Google Scholar 

  13. Pathania D, Senthil S, Rao HL et al (2014) Outcomes of trabeculectomy in juvenile open angle glaucoma. Indian J Ophthalmol 62:224–228

    Article  Google Scholar 

  14. Sidoti PA, Belmonte SJ, Liebmann JM, Ritch R (2000) Trabeculectomy with mitomycin-C in the treatment of pediatric glaucomas. Ophthalmology 107:422–429

    Article  CAS  Google Scholar 

  15. Beauchamp GR, Parks MM (1979) Filtering surgery in children: barriers to success. Ophthalmology 86:170–180

    Article  CAS  Google Scholar 

  16. Whiteside-Michel J, Liebmann JM, Ritch R (1992) Initial 5-fluorouracil trabeculectomy in young patients. Ophthalmology 99:7–13

    Article  CAS  Google Scholar 

  17. Badeeb OM (2008) Long term outcome of surgical management of congenital glaucoma. J Tabiah Univ Med Sci 3:92–103

    Google Scholar 

  18. Freedman SF, McCormick K, Cox TA (1999) Mitomycin C-augumented trabeculectomy with postoperative wound modulation in pediatric glaucoma. J AAPOS 3:117–124

    Article  CAS  Google Scholar 

  19. Dietlein TS, Jacobi PC, Krieglstein GK (1999) Prognosis of primary ab externo surgery for primary congenital glaucoma. Br J Ophthalmol 83:317–322

    Article  CAS  Google Scholar 

  20. Zhang X, Du S, Fan Q et al (2009) Long-term surgical outcomes of primary congenital glaucoma in China. Clinics (Sao Paulo) 64:543–551

    Article  Google Scholar 

  21. Susanna R Jr, Oltrogge EW, Carani J, Nicolela MT (1995) Mitomycin as adjunct chemotherapy with trabeculectomy in congenital and developmental glaucomas. J Glaucoma 4:151–157

    PubMed  Google Scholar 

  22. Giampani J Jr, Borges-Giampani AS, Carani JC et al (2008) Efficacy and safety of trabeculectomy with mitomycin C for childhood glaucoma: a study of results with long-term follow-up. Clinics (Sao Paulo) 63:421–426

    Article  Google Scholar 

  23. Al-Hazmi A, Awad A, Zwaan J et al (2005) Correlation between surgical success rate and severity of congenital glaucoma. Br J Ophthalmol 89:449–453

    Article  CAS  Google Scholar 

Download references

Funding

None to disclose.

Author information

Authors and Affiliations

  1. Department of Ophthalmology, Ankara Training and Research Hospital, Ankara, Turkey

    Gülizar Demirok, Güner Özkan, Umay Güvenç & Mehmet Yakın

  2. Department of Ophthalmology, Faculty of Medicine, Muğla Sıtkı Koçman University, Kotekli Mugla, 48000, Muğla, Turkey

    Ahmet Kaderli

  3. Department of Ophthalmology, Başkent University Faculty of Medicine, Ankara, Turkey

    Ümit Ekşioğlu

Authors
  1. Gülizar Demirok
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Güner Özkan
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Ahmet Kaderli
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Umay Güvenç
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Mehmet Yakın
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Ümit Ekşioğlu
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

All authors contributed to the study conception and design. The study was designed by GÜ and GD. Data were provided by ÜE as the chairmen of the contributing departments. Data collection was performed by GÜ, AK, MY and UG. The first draft of the manuscript was written by GD, and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Ahmet Kaderli.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest with this work.

Consent to participate

Retrospective study design.

Consent to publish

For this type of study (retrospective analysis), formal consent is not required.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Demirok, G., Özkan, G., Kaderli, A. et al. Factors affecting the surgical success of trabeculectomy performed as the first surgery in primary pediatric glaucoma. Int Ophthalmol 42, 2511–2518 (2022). https://doi.org/10.1007/s10792-022-02298-2

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10792-022-02298-2

Keywords

Search

Navigation