Influence of various factors on the efficiency of trabeculectomy in pediatric patients with congenital glaucoma

Abstract

AIM: The study aimed to analyze the influence of various factors on the efficiency of trabeculectomy in pediatric patients with congenital glaucoma.

MATERIAL AND METHODS: The results of 945 trabeculectomies, including those with various modifications and the use of drains, in pediatric patients with congenital glaucoma were analyzed in the Department of Pediatric Eye Pathology of the Helmholtz National Medical Research Center for Eye Diseases for 1997–2023.

RESULTS: The efficiency of trabeculectomy in pediatric patients with congenital glaucoma was 91.9%–98.5% in the immediate period (up to 6 months) after surgery, 75.5%–86.5% in the long term (after 5 years), and 34.2%–42.1% with repeated surgeries (up to 3–4 surgeries) during follow-up up to 10 years, which is comparable with literature data.

CONCLUSION: The main factors that influence the efficiency of trabeculectomy in pediatric patients with congenital glaucoma include age at the time of detection and surgical treatment of congenital glaucoma, their somatic health, glaucoma stage, and severity of destructive changes in the eye, particularly the congenital ones, presence of repeated surgeries, erroneous choice of the trabecular site subject to excision during surgery, injury rate of trabeculectomy (quality of incision of the conjunctiva, sclera, injury rate of vessel coagulation during surgery, and skill of the surgeon), presence of intra- and postoperative complications, untimely detection and YAG laser elimination of the internal fistula fusion after trabeculectomy, and inadequate management of the postoperative period.

Keywords

congenital glaucoma / sinustrabeculectomy / trabeculectomy / pediatric patients

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