LONG-TERM RESULTS OF TRABECULECTOMY FOR CONGENITAL GLAUCOMA

Background: To evaluate long-term results of intraocular pressure afte r trabeculectomy for congenital glaucoma. Methods: Data concerning 55 eyes (30 patients) who underwent trabeculectomy for congenital glaucom a were recorded. Mean age at diagnosis was 3.4 months (range: 2 days t o 10 months). Mean follow up was 56.8 months. Associated anterior segm ent abnormalities, need for one or more new trabeculectomy procedures during follow up, and intraocular pressure at the last examination wer e noted. Results: Of the 55 eyes, 48 met the success criteria (87.3%), A second and sometimes third or fourth trabeculectomy were necessary during follow up in 17 eyes (31%). Of the seven failures at final exam ination, six (85%) had been diagnosed and operated on before the age o f 1 month, whereas 15 of the 48 eyes with good results (31.2%) were in this group (p<0.02). Of the seven failures at final examination, six (85%) were operated on two to four times, whereas 10 of the 48 eyes wi th good results (20.1%) were in this group (p<0.01). An associated ant erior segment abnormality was present in 13 eyes (23%), and did not se em to influence the final outcome. Conclusion: Trabeculectomy is an ef fective procedure for long-term control of intraocular pressure in con genital glaucoma. The early diagnosis and surgical treatment correspon d to a poor long-term prognosis, probably related to initially severe cases. In these cases, intraocular pressure is difficult to control de spite repeated surgical procedures.