The Long-term Visual Outcomes of Primary Congenital Glaucoma
Kiana Hassanpour1 , Hamed Esfandiari2 *, Alisa Prager2
- Ophthalmic Research Center, Institutue for Ophthalmology and Vision Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Department of Ophthalmology, Northwestern University Feinberg School of Medicine, Chicago, USA3
Abstract: To evaluate the long-term visual outcomes of ab externo trabeculotomy for primarycongenital glaucoma (PCG) at a single pediatric ophthalmology center
Methods: In this retrospective single-center case series, data from 63 eyes of 40 patientswho underwent ab externo trabeculotomy between September 2006 and June 2018 wereincluded. The data were analyzed for best corrected visual acuity (BCVA), stereopsis, andsurgical success. Kaplan–Meier analysis was performed using the surgical success criteriadefined as intraocular pressure (IOP)≤21 mmHg and≥20% below baseline without theneed for additional glaucoma surgery.
Results: BCVA at the time of diagnosis was 0.37 ± 0.48 logMAR, which changed to 0.51 ± 0.56 logMAR at the final follow-up (P = 0.08). Twenty-five percent of patients had BCVA equal to or better than 20/40 at the final visit. The mean refraction at baseline was -4.78 ± 5.87 diopters, which changed to less myopic refraction of -2.90 ± 3.83 diopters at the final visit. Optical correction was prescribed in 66% of eyes at the final visit. The average final stereopsis was 395.33 sec of arc. The linear regression model showed a significant association between the surgery success rate and final BCVA as well as stereoacuity (P-values: 0.04 and 0.03, respectively). Intraocular pressure (IOP) decreased significantly from 29.79 ± 7.67 mmHg at baseline to 16.13 ± 3.41 mmHg at the final follow-up (P = 0.001).
Conclusion: Patients with PCG can achieve an acceptable visual acuity and stereoacuity, particularly in cases of timely intervention and close follow-up.
