INTRAOCULAR PRESSURE DECREASE IN SURGICAL TREATMENT FOR CONGENI-TAL GLAUCOMA

Purpose: To evaluate results of intraocular pressure decrease in surgical procedures for congenital glaucoma We reviewed our experience with goniotomy, trabeculotomy, trabeculectomy and the combined procedure during the last 23 years. Methods: Pre-operative and postoperative intraocular pressures concerning 104 eyes (64 patients) that underwent goniotomy (45 eyes), trabeeu-lotoray (25 eyes), trabeculectomy alone (15 eyes) or a combined trabeculotomy-trabeculectomy (19 eyes) as a primary surgical procedure for congenital glaucoma were recorded. Follow up ranged from 1 month to 77 months (mean: 6.4 months). Intraocular pressure was measured by Schiotz or hand-held applanation tonometry with the patient under anesthesia Results: Mean pre-treatment intraocular pressure in 104 eyes was 27.3 (SD 5.3) mmHg, decreasing to 19.9 (SD 7.5) mmHg following treatment with a single surgical procedure. Combined trabeculotomy-trabeculectomy and trabeculectomy alone were the most successful as the initial operation, decreasing mean intraocular pressure to 15.2 (SD 6.4) and 16.7 (SD 9.2)mmHg, respectively. Surgical results with goniotomy and trabeculotomy, decreased mean intraocular pressure to 21.0 (SD 6.2) and 23.6 (SD 7.1) mmHg, respectively. Conclusion: Our results indicate that trabeculectomy (either alone or combined with trabeculotomy) is an efficient surgical procedure to control of intraocular pressure in primary congenital glaucoma. With goniotomy or trabeculotomy we had disappointing surgical results.