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

OBJECTIVE

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.