Nermina Mustafic1, Gulsah Bakar1, Joanna Black2, John Pater1,2, Stewart Lake1, Deepa Taranath1,2, Jamie Craig1
To determine the effectiveness and common complications of GDD surgery in children diagnosed with primary congenital glaucoma (PCG) and secondary glaucoma.
Analysis of patient files encompassing GDD surgery between 2005 and 2015, from Flinders Medical Centre and Women’s and Children’s Hospital in South Australia. Same surgeons performed GDD surgery (J.C.) and adjunct vitrectomy (S.L.). Data extracted included patient demographics, diagnosis, glaucoma related, and anterior segment investigations. Success was defined as IOP ? 21 with or without medical therapy at follow up, loss of light perception and no further major surgical intervention.
A total of 16 patients and 20 eyes were analysed; 5/20 (25%) diagnosed with PCG, and 15/20 (75%) as secondary glaucoma (60% Aphakic Glaucoma; 13.3% Anterior Segment Dysgenesis; 6.7% Sturge-Webber Syndrome; 6.7% Aniridic; 6.7% Traumatic; 6.7% Uveitic). In 95% of cases, Baerveldt tube was inserted and Molteno 3 in the remainder 5%; a 55% anterior, and 45% Pars Plana placement (90% had adjunct vitrectomy procedure).
84% were considered successful outcomes. Furthermore, 33.3% decreased in number of medication, and 44.4% stable on zero medication. We acknowledge one eye was excluded due to anterior segment fibrosis making IOP measurement impossible. IOP >21 mmHG was in 2 eyes, with ongoing treatment. Failure was attributed to one eye with retinal detachment causing blindness.
Complications persisting after the early postoperative period included long-term hypotony (IOP <5mmHg), 15% in Secondary and 5% in PCG, and cataract development (50%) amongst phakic eyes, of which 50% needed surgery. In 30% of cases further tube revision was necessary.
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