Prognosis in juvenile glaucoma after trabeculectomy

Purpose:
to evaluate the efficacy of trabeculectomy in the patients with juvenile glaucoma in the long-term follow-up.

Material and methods:
in 22 of 37 patients - 41 trabeculectomies with basal iridectomy were performed. The age of children ranged from 6 to 18 years, mean 12,4 years. In one eye of 15-year-old boy we used Mitomycin C during reoperation. The follow-up period ranged from 2 to 14 years, mean 8 years. Patients were divided into 2 groups depending on the follow-up: I group (19 eyes) was observed 2-6 years, mean 5,1 years, II group (18 eyes) 7-14 years, mean 11,1 years. In the I group 57,9% and in the II group 61% of children were myopic.

Results:
intraocular pressure lower or equal to 21 mmHg with no glaucoma medication was obtained in 79% of eyes in the I group and 66,7% of eyes in the II group. The difference was not statistically significant. In other eye local application of B-blockers and dorzolamid decreased intraocular pressure to values safe for the optic nerve, what was monitored by visual acuity and laser scanning tomography.

Conclusions:
Prognosis of juvenile glaucoma patients treated with trabeculectomy is satisfactory but the effectiveness of this procedure decreases together with the elongation of the follow-up period.