Long term visual & surgical outcomes of trabeculectomy for p
A Study was conducted to evaluate the long-term visual and surgical outcomes, and associated risk factors for poor outcomes in patients with primary congenital glaucoma (PCG).

Retrospective review of medical records was done of children who underwent combined trabeculotomy trabeculectomy (CTT) without mitomycin-C as the first surgical procedure. Success was defined as intraocular pressure (IOP) less than 16 mmHg without (complete) or with (qualified) one glaucoma medication. The WHO criteria of vision loss was used to categorize the levels of vision impairment (VI). For purposes of statistical analysis, one eye of patients for bilateral PCG and affected eye in unilateral PCG was randomly chosen.

--The cohort included 653 consecutive PCG patients, of whom 475 underwent simultaneous bilateral CTT.

--Kaplan-Meier survival analysis revealed 1-, 5-, 10-, 15-, and 19-year complete success rates of 92.6%, 75.5%, 55.9%, 44.7%, and 21.6% (n = 3), respectively.

--Multivariate analysis revealed independent associations between failure, preoperative corneal clarity, and prior glaucoma surgery.

--Mean follow-up was 41 ± 51 months. Of the visual acuity (VA) data in the affected eyes obtained at last follow-up (n = 333), 74 patients had VA of more than 6/12.

--Of the remaining 259 patients, 18 had mild VI, 87 had moderate VI, 58 had severe VI, and 96 were blind. No serious complications were noted.

Conclusively, Primary CTT may be safely employed to control IOP and may provide long-term benefits in PCG patients.

Source: https://onlinelibrary.wiley.com/doi/10.1111/aos.14984?af=R