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Early-onset glaucoma in Axenfeld-Rieger anomaly: long-term surgical results and visual outcome.
Eye (Lond). 2016 Jul; 30(7):936-42.E

Abstract

PurposeTo determine the long-term surgical and visual outcomes in Indian children with early-onset glaucoma associated with Axenfeld-Rieger anomaly (ARA).MethodsThis is a retrospective analysis of 44 eyes of 24 consecutive children with early-onset glaucoma (within 3 years of age) and ARA who underwent glaucoma surgery over a 20-year period (1991-2010) by a single surgeon. Main outcome measures were pre- and postoperative intraocular pressures (IOPs), corneal clarity, visual acuities (VAs), refractive errors, success rate, time of surgical failure, and complications.ResultsThe series consisted of 38 primary combined trabeculotomy-trabeculectomy (CTT) and 6 primary trabeculectomy procedures (Schlemm's canal could not be identified in these eyes). There was a statistically significant reduction in IOP postoperatively (27.07±4.88 vs 14.88±3.62 mm Hg; P<0.0001) with a mean reduction of 45.14%. Success probability by Kaplan-Meier survival analysis was 93% till 5 years, and then 88.1%, 82.3%, 70.5%, 56.4%, and 42.3% at year 6, 7, 8, 9, and 10, respectively. Preoperative corneal edema was present in 43/44 eyes (97.72%) and cleared in 42 eyes (97.67%). There was one case each with intraoperative hyphema and with shallow chamber postoperatively and both were successfully managed successfully. There was no incidence of endophthalmitis or any other sight-threatening complication. Data on VA were available in 34 eyes (77.3%). At final follow-up visit, 15 (44.1%) eyes had best corrected VA ⩾6/18.ConclusionsPrimary CTT is safe and effective for early-onset glaucoma associated with ARA. It leads to excellent IOP control and satisfactory visual outcome.

Authors+Show Affiliations

Jasti V Ramanamma Children's Eye Care Centre, Kallam Anji Reddy Campus, LV Prasad Eye Institute, Hyderabad, India.The David Brown Children's Eye Care Centre, Kode Venkatadri Chowdary Campus, Vijayawada, India.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

27055677

Citation

Mandal, A K., and N Pehere. "Early-onset Glaucoma in Axenfeld-Rieger Anomaly: Long-term Surgical Results and Visual Outcome." Eye (London, England), vol. 30, no. 7, 2016, pp. 936-42.
Mandal AK, Pehere N. Early-onset glaucoma in Axenfeld-Rieger anomaly: long-term surgical results and visual outcome. Eye (Lond). 2016;30(7):936-42.
Mandal, A. K., & Pehere, N. (2016). Early-onset glaucoma in Axenfeld-Rieger anomaly: long-term surgical results and visual outcome. Eye (London, England), 30(7), 936-42. https://doi.org/10.1038/eye.2016.66
Mandal AK, Pehere N. Early-onset Glaucoma in Axenfeld-Rieger Anomaly: Long-term Surgical Results and Visual Outcome. Eye (Lond). 2016;30(7):936-42. PubMed PMID: 27055677.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Early-onset glaucoma in Axenfeld-Rieger anomaly: long-term surgical results and visual outcome. AU - Mandal,A K, AU - Pehere,N, Y1 - 2016/04/08/ PY - 2015/08/29/received PY - 2016/02/14/accepted PY - 2016/4/9/entrez PY - 2016/4/9/pubmed PY - 2017/3/17/medline SP - 936 EP - 42 JF - Eye (London, England) JO - Eye (Lond) VL - 30 IS - 7 N2 - PurposeTo determine the long-term surgical and visual outcomes in Indian children with early-onset glaucoma associated with Axenfeld-Rieger anomaly (ARA).MethodsThis is a retrospective analysis of 44 eyes of 24 consecutive children with early-onset glaucoma (within 3 years of age) and ARA who underwent glaucoma surgery over a 20-year period (1991-2010) by a single surgeon. Main outcome measures were pre- and postoperative intraocular pressures (IOPs), corneal clarity, visual acuities (VAs), refractive errors, success rate, time of surgical failure, and complications.ResultsThe series consisted of 38 primary combined trabeculotomy-trabeculectomy (CTT) and 6 primary trabeculectomy procedures (Schlemm's canal could not be identified in these eyes). There was a statistically significant reduction in IOP postoperatively (27.07±4.88 vs 14.88±3.62 mm Hg; P<0.0001) with a mean reduction of 45.14%. Success probability by Kaplan-Meier survival analysis was 93% till 5 years, and then 88.1%, 82.3%, 70.5%, 56.4%, and 42.3% at year 6, 7, 8, 9, and 10, respectively. Preoperative corneal edema was present in 43/44 eyes (97.72%) and cleared in 42 eyes (97.67%). There was one case each with intraoperative hyphema and with shallow chamber postoperatively and both were successfully managed successfully. There was no incidence of endophthalmitis or any other sight-threatening complication. Data on VA were available in 34 eyes (77.3%). At final follow-up visit, 15 (44.1%) eyes had best corrected VA ⩾6/18.ConclusionsPrimary CTT is safe and effective for early-onset glaucoma associated with ARA. It leads to excellent IOP control and satisfactory visual outcome. SN - 1476-5454 UR - https://www.unboundmedicine.com/medline/citation/27055677/Early_onset_glaucoma_in_Axenfeld_Rieger_anomaly:_long_term_surgical_results_and_visual_outcome_ L2 - https://doi.org/10.1038/eye.2016.66 DB - PRIME DP - Unbound Medicine ER -