Clinical effect of improved viscocanalostomy for the treatment of primary congenital glaucoma

AIM: To evaluate the clinical effect of improved viscocanalostomy in patients with primary congenital glaucoma. METHODS: Retrospective analysis of improved viscocanalostomy was performed on 51 eyes of 42 patients with primary congenital glaucoma. The outcome evaluation included postoperative intraocular pressure (IOP), corneal diameter, cup/disc ratio and complications. All patients were followed up at week 1, month 1, 3, 6 and 12. RESULTS: The results revealed that postoperative IOP was decreased from (38.57 +/- 13.61)mmHg to (10.53 +/- 3.91)mmHg. (14.89 +/- 5.26)mmHg,(15.42 +/- 5.11)mmHg, (13.82 +/- 3.46)mmHg, (13.16 +/- 5.29)mmHg at follow-up time of 1 week,1, 3, 6, 12 months (P<0.001). The postoperative corneal diameter was decreased significantly (P=0.002); The mean cup/dish ratio wasn't significantly different (P=0.148) before and after the surgery, the cup/dish ratio of successful surgery was evidently decreased (preoperative 0.7 +/- 0.2, postoperative 0.6 +/- 0.3, P = 0.007), but the complications like unformed anterior chamber were not observed. The mean follow-up period was 12 months. CONCUJSION: Improved viscocanalostomy improves the clinical effects of the patients with primary congenital glaucoma, such as higher success rates, lower postoperative mean IOP and fewer complications.

Seven-year follow-up of spontaneously resolved primary congenital glaucoma:a case report

Background:Spontaneously resolved primary congenital glaucoma is rare and the mechanism remains unknown.Previous literature described the phenomenon of spontaneous resolution of primary congenital glaucoma,with no further reports on follow-up visits and visual development of patients.We report a case of unilateral spontaneously resolved primary congenital glaucoma at a 7-year follow-up visit and describe the differential development of axial length(AL)between affected eye and healthy eye.Case Description:A 6-year-old boy firstly presented at Zhongshan Ophthalmic Center with expanded corneas and ruptures in Descemet’s membranes(Haab’s striae)and apparently thin retinal nerve fiber layer(RNFL)in the left eye(LE),but normal intraocular pressure(IOP)of both eyes without anti-glaucoma medications or surgeries.At 7-year follow-up,the IOPs of bilateral eyes were stable ranging from 8 to 11 mmHg.A cup to disc ratio and the RNFL was stable in the LE at the following visit.The AL increased almost 3 mm in the right eye(RE)but 1.5 mm in the LE.Without anti-glaucoma medications or surgeries,the primary congenital glaucoma was spontaneously resolved.Conclusions:It may figure out the development and influence of the affected eye of the patient,including AL and refraction state with regular ophthalmic examination at periodic follow-up.

A retrospective and consecutive study of viscocanalostomy versus trabeculectomy for primary congenital glaucoma

Background Surgical interventions are the main treatment for primary congenital glaucoma （PCG）. This study aimed to compare the efficacy and safety between viscocanalostomy and mitomycin C （MMC）-trabeculectomy in patients with PCG. Methods A total number of 43 patients with PCG who underwent either viscocanalostomy （group 1） or MMC- trabeculectomy （group 2） between June 2003 and June 2008 were retrospectively reviewed. The patients＇ intraocular pressures （lOPs） were examined before surgery and on day 1, week 1, month 1, month 6, and month 12 post-operative. Mean horizontal corneal diameters, success rates, intra- and post-operative complications were compared between the two groups. Results Pre-operative lOPs were （31.96±3.90） mmHg in group 1 and （32.56±4.00） mmHg in group 2. At the last visit, lOPs were （16.78±2.20） mmHg and （15.77±2.60） mmHg, respectively （P 〈0.001）; the complete success rates of group 1 and group 2 were 45.9% and 67.4%, respectively, and the difference was not statistically significant （P=0.158）. There were no major complications occurred in the two groups. Conclusions Both viscocanalostomy and trabeculectomy can lower lOP in PCG patients effectively. Although there was no major complications occurred in both groups, viscocanlostomy may decrease the probability of postoperative haemorrhage, hypotony, cataract, or choroid effusion.