MEDICAL AND SURGICAL ASPECTS OF CONGENITAL GLAUCOMA

During the years 1977-1986, 338 patients at the University Eye Clinic were diagnosed as having congenital glaucoma. This paper presents our experience of the management of 88 of these patients (161 eyes) who ha d a follow-up of at least 3 years, Medical therapy alone reduced the i ntraocular pressure to less than 21 mmHg in 17 eyes (11.8%) in the sho rt-term and in 14 eyes (9.7%) in the long-term, Surgical intervention in 127 eyes (goniotomy: 9 eyes; trabeculotomy: 3 eyes; peripheral irid encleisis: 4 eyes; Elliott trephine; 23 eyes; trabeculectomy: 88 eyes) , resulted in an immediate normalization of intraocular pressure in 98 eyes (77%, reducing to 66% at the final examination). Trabeculectomy normalized the intraocular pressure in 84% of eyes in the shortterm an d 76% in the long-term. Trabeculectomy is recommended as the surgical management of choice in congenital glaucoma in societies where present ation is late, or where individual surgeons may not be conversant with goniotomy.