TRABECULOTOMY IN JUVENILE PRIMARY OPEN-ANGLE GLAUCOMA

Long-term results of trabeculotomy in juvenile primary open-angle glau coma (JPOAG) were investigated based on a follow-up study of 16 eyes i n 11 patients, diagnosed when they were between 10 and 45 years old. P reoperative visual field defects were found in 75% (12/16) of the eyes . After a mean follow up of 7 years (range, 1 to 18 years), 88% (14/16 ) of the eyes had an intraocular pressure (IOP) of 21 mm Hg or less (p eak pressure at diurnal curves). Nine of these were receiving no medic al treatment and five were being treated with beta-blockers and/or dip ivefrin. The best results were in the younger patients; the success ra te of those under age 40 years was 100%. After normalization of IOP vi sual field testing showed no progression in defects. We conclude that trabeculotomy rather than filtering surgery should be used to treat JP OAG, because the success rate of filtering surgery decreases with decr easing age. Also, the good functional results achieved in these patien ts after normalization of IOP may indicate that ocular hypertension is the only risk factor in JPOAG.