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Primary combined trabeculotomy-trabeculectomy for early-onset glaucoma in Sturge-Weber syndrome.

AbstractOBJECTIVE:
To evaluate the safety and efficacy of primary combined trabeculotomy-trabeculectomy in the management of early-onset glaucoma associated with Sturge-Weber syndrome (SWS).
DESIGN:
Retrospective noncomparative case series.
PARTICIPANTS:
Ten eyes of nine patients were included in this study. All patients with SWS who underwent primary combined trabeculotomy-trabeculectomy from January 1993 through December 1996 were included. One patient had bilateral surgery.
INTERVENTION:
Primary combined trabeculotomy-trabeculectomy.
MAIN OUTCOME MEASURES:
Pre- and postoperative intraocular pressures (IOPs), corneal clarity and diameters, visual acuities, success rate, bleb characteristics, time of surgical failure (if any), and complications.
RESULTS:
The mean preoperative IOP was 28.2 mmHg +/- 7.35 mmHg with medication (mean, 1.2 +/- 0.6; range, 0-2). The mean postoperative IOP was 11.8 mmHg +/- 1.8 mmHg, with a mean percent reduction of 55.8 +/- 12.6 in IOP (P < 0.0001). All eyes maintained a postoperative IOP < 16 mmHg without medication over a mean follow-up of 27.6 +/- 16.4 months (range, 12-64 months). Normal corneal clarity was achieved in all eight eyes that had corneal edema. There were no significant intraoperative complications. Postoperatively, one patient developed a shallow anterior chamber with choroidal detachment, which was successfully managed conservatively.
CONCLUSION:
Primary combined trabeculotomy-trabeculectomy is safe, effective, and sufficiently predictable to be considered the first choice of surgical treatment in early-onset glaucoma associated with SWS.
AuthorsA K Mandal
JournalOphthalmology (Ophthalmology) Vol. 106 Issue 8 Pg. 1621-7 (Aug 1999) ISSN: 0161-6420 [Print] United States
PMID10442913 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
Topics
  • Child
  • Child, Preschool
  • Cornea (physiology)
  • Female
  • Glaucoma (etiology, surgery)
  • Humans
  • Infant
  • Intraocular Pressure
  • Male
  • Postoperative Complications
  • Retrospective Studies
  • Safety
  • Sturge-Weber Syndrome (complications)
  • Trabeculectomy
  • Treatment Outcome
  • Visual Acuity

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