• Clinics · Jan 2009

    Comparative Study

    Long-term surgical outcomes of primary congenital glaucoma in China.

    • Xiulan Zhang, Shaolin Du, Qian Fan, Shouxiong Peng, Minbin Yu, and Jian Ge.
    • Glaucoma Department, Zhongshan Ophthalmic Centre, State Key Laboratory of Ophthalmology, Sun Yat-sen University, Guangzhou, China.
    • Clinics (Sao Paulo). 2009 Jan 1; 64 (6): 543551543-51.

    ObjectiveTo evaluate the long-term outcomes of three surgical procedures for the treatment of primary congenital glaucoma (PCG).IntroductionPCG is one of the main causes of blindness in children. There is a paucity of contemporary data on PCG in China.MethodsA retrospective study of 48 patients (81 eyes) with PCG who underwent primary trabeculectomy, trabeculotomy, or combined trabeculotomy and trabeculectomy (CTT).ResultsAll patients were less than 4 years (yrs) of age, with a mean age of 2.08 +/- 1.23 yrs. The mean duration of follow-up was 5.49 +/- 3.09 yrs. The difference in success rates among the three surgical procedures at 1, 3, 6 and 9 yrs was not statistically significant (p = 0.492). However, in patients with over 4 yrs of follow-up, Kaplan-Meier survival analysis revealed that the success rates of trabeculectomy and CTT declined more slowly than that of trabeculotomy. Among the patients, 66.22% acquired good vision (VA > 0.4), 17.57% acquired fair vision (VA = 0.1 - 0.3), and 16.22% acquired poor vision (VA < 0.1). The patients with good vision were mostly in the successful surgery group. Myopia was more prevalent postoperatively (p = 0.009). Reductions in the cup-disc ratio and corneal diameter were only seen in the successful surgery group (p = 0.000). In addition, the successful surgery group contained more patients that complied with a regular follow-up routine (p = 0.002).DiscussionOur cases were all primary surgeries. Primary trabeculectomy was performed in many cases because no treatment was sought until an advanced stage of disease had been reached.ConclusionsIn contrast to most reports, in the present study, trabeculectomy and CTT achieved higher long-term success rates than trabeculotomy. The patients with successful surgical results had better vision. Compliance with a routine of regular follow-up may increase the chances of a successful surgical outcome.

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