Goniosurgery for prevention of aniridic glaucoma

Objective: To report the long-term success and complications of modified go niosurgery to prevent aniridic glaucoma, an entity that typically is diffic ult to control medically or surgically. Design: A retrospective review of the medical charts. Results: Fifty-five eyes in 33 patients who had aniridia without glaucoma a nd who underwent goniosurgery were identified. Ninety-one procedures were p erformed on the SS eyes by 1 surgeon (D.S.W.). Each eye had an average of 1 .65 procedures and an average of 200 degrees of goniosurgery. Average age a t time of initial goniosurgery was 36.6 months. There were no operative com plications. No eye had a decrease in visual acuity at last follow-up. All e yes had a preoperative intraocular pressure (IOP) less than 21 mm Hg. At la st follow-up (average, 9 years 6 months; range, 8 months to 24 years), 49 e yes (89%) had IOPs less than 22 mm Hg without medications. The remaining 6 eyes (11%) had IOPs of 22 nlm Hg or less with up to 2 types of eyedrops. Conclusions: Without prophylactic goniotomy, aniridic glaucoma may be expec ted in half of patients, and when it occurs, it is extremely difficult to c ontrol. Prophylactic goniosurgery in selected eyes of young patients with a niridia may be effective in preventing aniridic glaucoma.