Original ArticlesTrabeculectomy with adjunctive mitomycin C in pediatric glaucoma☆
Section snippets
Patients and methods
A retrospective review of medical records identified all patients 17 years of age or less with glaucoma who underwent trabeculectomy with intraoperative application of mitomycin C (55 consecutive patients, 68 eyes) between January 1991 and December 1995 at Emory University Affiliated Hospitals. The results of all trabeculectomies with mitomycin C were recorded, with statistical analysis performed on one eye of each patient (first eye of each patient who had bilateral surgery). Forty-nine
Results
Patients were categorized by the Shaffer-Weiss classification system, with the inclusion of glaucoma associated with aphakia after congenital cataract surgery as a new category.16 The following diagnoses were noted (N = 60 eyes): 14 with primary congenital glaucoma; 10 with anterior segment dysgenesis (Axenfeld-Rieger and Peter anomaly); 9 with aniridia; 9 with glaucoma after congenital cataract extraction; 4 with traumatic glaucoma; 4 with persistent hyperplastic primary vitreous; 3 with
Discussion
Trabeculectomy without adjunctive antimetabolites in pediatric patients (less than 18 years of age) has a successful outcome in 30% to 50% of cases.1, 2, 3 The 50% rate is from a study with relatively short follow-up (mean, 15.5 months).3 Studies with longer follow-up note a success rate of 30% to 35%.1, 2 Trabeculectomy has been utilized as an initial procedure in primary congenital glaucoma with higher success rates (54% to 87%), although with lower success rates than those noted for
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Cited by (137)
Outcomes of Goniotomy With or Without Secondary Intraocular Lens Implantation in Pediatric Glaucoma Following Cataract Surgery: A Prospective Pilot Study
2023, Asia-Pacific Journal of OphthalmologyAngle closure glaucoma in congenital ectropion uvea
2018, American Journal of Ophthalmology Case ReportsCitation Excerpt :In our series, in all 3 cases the angles were closed and thus the options of trabeculectomy with antifibrotic medication or glaucoma drainage device implantation were discussed with the patient and their parents. Due to factors related to the increased life-long risk of trabeculectomy-related infections,16–19 all three teenagers opted for glaucoma drainage device placement. Interestingly, in all of our cases, there was early encapsulation of the plates and the 3 eyes required additional glaucoma surgery (cycloablation or trabeculectomy with mitomycin C) within 4 months of tube implantation.
360-Degree Trabeculotomy for Medically Refractory Glaucoma Following Cataract Surgery and Juvenile Open-Angle Glaucoma
2017, American Journal of OphthalmologyCitation Excerpt :Finally, trabeculectomy with or without mitomycin C (MMC) has often been used for medication-refractory JOAG and other refractory cases. With reported success of 56%–95% in pediatric glaucoma, filtration surgery also carries risk of vision-threatening complication.35–37 Success of trabeculectomy, even augmented with MMC, has been reported proportional to patient age, as reported by Beck and associates and Al-Hazmi and associates, with increased risk of failure associated with aphakic status and younger age.36,38
Trabeculectomy bleb-associated infections
2017, Survey of OphthalmologySlow coagulation versus micropulse transscleral cyclophotocoagulation for refractory childhood glaucoma
2024, European Journal of Ophthalmology
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Supported in part by an unrestricted grant from Research to Prevent Blindness, Inc, New York, New York, and a core grant EY06360 from the National Eye Institute, Bethesda, Maryland (Drs Beck, Lynch, and Lynn).