[Deep sclerectomy in congenital glaucoma: results of a study lasting more than 3 years].

PURPOSE

To assess the outcome of deep sclerectomy surgery with intraoperative antimitotic application in children with primary and secondary congenital glaucomas.

PATIENTS AND METHODS

Thirty-seven eyes of 22 children aged from 1 day to 14 years were included in this study; 30 eyes had primary congenital glaucoma and were divided into two groups according to the management delay. Eighteen eyes were managed early (group 1) and 12 eyes were diagnosed late (group 2). Finally, seven eyes had a more complex dysgenic glaucoma (group 3). All the eyes had a deep sclerectomy with antimitotic intraoperative application (5 FU). Pre- and postoperative intraocular pressures, success rate, preoperative corneal transparency, corneal diameter, and surgical complications were assessed. Total success was defined by final postoperative intraocular pressure lower than 16 mmHG without combined medical treatment; partial success was defined by lower than 16 mmHG with a combined medical treatment.

RESULTS

The mean follow-up was 38.2 months. Total success was 34% and partial was 82%: 56% and 89%, respectively, for group 1, 33% and 100% for group 2, and 14% and 57% for group 3. No severe complications occurred after surgery.

CONCLUSION

The probability of success was significantly lower for secondary congenital glaucomas and for primary congenital glaucomas with late management. Management delay and the type of glaucoma seem to be capital in the prognosis of high intraocular pressure. Deep sclerectomy with antimitotic application (5 FU) is a good alternative to trabeculectomy in primary glaucomas.