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Long-term Outcome of Trabeculotomy for the Treatment of Developmental Glaucoma
Hanako Ikeda, MD;
Hitoshi Ishigooka, MD;
Tomoyuki Muto, MD;
Hidenobu Tanihara, MD;
Makoto Nagata, MD
Arch Ophthalmol. 2004;122:1122-1128.
Objective To elucidate long-term outcome of trabeculotomy in primary and secondary developmental glaucoma.
Methods One hundred forty-nine eyes of 89 patients with developmental glaucoma who underwent trabeculotomy were retrospectively studied. Intraocular pressure (IOP), success probabilities, visual acuities, and visual field were determined during follow-up and at the final visit.
Results The mean ± SD IOP of 112 eyes with primary developmental glaucoma at the final visit with an mean ± SD follow-up period of 9.5 ± 7.1 years was 15.6 ± 5.0 mm Hg. The average IOP for 37 eyes with secondary developmental glaucoma was 16.7 ± 4.2 mm Hg. One hundred eyes (89.3%) with primary developmental glaucoma were defined as achieving success at the final visit. Complete and qualified successes were achieved in 71 eyes (63.4%) and 29 eyes (25.9%), respectively. Visual acuities were 20/40 or better in 78 (59.5%) of 131 eyes examined and were poorer than 20/200 in 32 eyes (24.4%). The causes of poor visual acuities were mainly progression of glaucoma, including delay of detection of onset or surgery and amblyopia. Eyes with glaucoma that existed before 2 months of age or eyes that needed several trabeculotomies were considered to have poor visual acuity. Visual fields were classified as normal or almost normal in 21 (44.7%) of 47 eyes.
Conclusions Trabeculotomy for developmental glaucoma is effective over a long time. There is a fairly good prognosis for visual function of eyes with developmental glaucoma with early detection of the onset, proper treatment, and proper management after trabeculotomy.
From the Department of Ophthalmology, Tenri Hospital, Nara, Japan (Drs Ikeda, Ishigooka, and Muto); Organogenesis and Neurogenesis Group, Center for Developmental Biology, RIKEN, Kobe, Japan (Dr Ikeda); Department of Ophthalmology, Kumamoto University School of Medicine, Kumamoto, Japan (Dr Tanihara); and Nagata Eye Clinic, Nara, Japan (Dr Nagata). The authors have no relevant financial interest in this article.
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