Long- and mid-term results after trabeculotomy in juvenile an late-juvenile open-angle glaucoma

Background: To determine success rate of trabeculotomy in patients with juv enile and late-juvenile glaucoma in a retrospective study. Patients and Methods: 46 eyes of 41 juvenile glaucoma-patients (24 female, 17 male) were submitted to trabeculotomy during the period of 1980-1997. Pa tients age at the time of surgery was 30.2 +/- 10.5 years (11-49 years, med ian 21 years). Follow-up time was 35 +/- 46 months (1-155 months). Results: Median preoperative visual acuity was 1.0 (range 0.002 to 1.25), p ostoperative visual acuity at the end of the follow up period was 0.8 (medi an) with a range from 0.002 to 1.2. in all patients preoperative intraocula r pressure was elevated and a glaucomatous configuration of the optic disc was noticed. Preoperative intraocular pressure (IOP) ranged from 30.5 +/- 1 3.2 mm Hg, after surgery IOP was 16.2 +/- 5 mm Hg. Mean decrease of the IOP postoperatively was 54.4%. In 37% of the eyes IOP was lower than 23 mm Hg without additional medication, in 47% of the eyes IOP was lower than 23 mm Hg with additional medication. In 8 eyes additional antiglaucoma-surgery wa s necessary. After a follow-up time of 60 months 81% of the patients (n = 3 7 eyes) had an IOP below 23 mm Hg, after 120 months in 80% of the patients (n = 29 eyes) IOP was below 23 mm Hg. Conclusion: The success rate of trabeculotomy (defined as the ability to lo wer intraocular pressure lower than 23 mm Hg with or without antiglaucoma m edication) in our patients is 84%. After second operation, success rate is 89%. Trabeculotomy for patients with juvenile open angle glaucoma is a safe procedure and avoids problems and complications of filtering procedures.