Long-term visual results following primary trabeculectomy for infantile glaucoma

Purpose: To report the long-term visual outcome of eyes that underwent prim ary trabeculectomy for infantile glaucoma and to evaluate factors that affe ct visual prognosis. Methods: Thirty-five eyes of 22 consecutive patients presenting between 198 0 and 1995 were included. Visual acuity, visual fields and refractive statu s were assessed and patient records reviewed. Results. Nineteen of 22 patients (86.3%) achieved 6/12 or better, (21 of 35 eyes; 60%). Reasons for decreased vision included amblyopia (5 eyes), fiel d loss (4 eyes), corneal opacification (2 eyes), and uncontrolled IOP (1 ey e). Primary glaucoma had a better outcome than secondary glaucoma. Vision w as frequently unequal despite controlled pressure, clear media and full fie lds in both eyes. This was associated with myopic anisometropia and apparen t amblyopia. Ten patients responded to patching. Eyes with field defects we re unresponsive to patching. Conclusions. Field defects, corneal scarring, marked anisometropia and seve re astigmatism result in poor vision. Anisometropic amblyopia is frequently present and responds well to patching. Visual outcome is dependent on earl y and sustained control of intraocular pressure and aggressive treatment of amblyopia.