SURGICAL RESULTS OF SECONDARY GLAUCOMAS IN CHILDHOOD

Objective: This study aimed to describe results of glaucoma surgeries performed at one institution over the past 20 years in children with a phakia, aniridia, anterior segment dysgenesis, and other secondary gla ucomas. Design: The study design was a retrospective review. Participa nts: Fifty-eight eyes of 40 patients were studied. Intervention: Trabe culectomy with or without mitomycin C, Molteno implantation, goniotomy , sclerostomy, endolaser cyclophotocoagulation, and cyclocryotherapy w ere performed, Main Outcome Measures: Intraocular pressure (IOP) contr ol, defined as complete success (IOP less than or equal to 21 without medications) or qualified success (IOP less than or equal to 25 withou t medications or IOP less than or equal to 21 with medications) and po stoperative visual acuity stability were assessed. Results: One hundre d thirty surgical procedures were performed on 58 eyes of 40 patients; follow-up averaged 7.3 years. Intraocular pressure control was achiev ed in 40 (70%) of 57 eyes after 1 or more procedures, Intraocular pres sure control and stabilization of visual acuity and optic disc appeara nce were achieved in 28 (51%) of 55 eyes, Five eyes had significant po stoperative complications, Trabeculectomy with mitomycin C controlled IOP on last visit in 8 of 13 eyes with aphakic glaucoma. Conclusions: Surgical intervention can control IOP and prevent visual loss in child ren with secondary glaucomas. In the authors' experience, a filtering procedure is the most effective treatment in aphakic glaucoma and ante rior segment dysgenesis.