Efficacy and safety of trabeculectomy with mitomycin C for childhood glaucoma: a study of results with long-term follow-up.
Clinics (Sao Paulo)
; 63(4): 421-6, 2008 Aug.
Article
em En
| MEDLINE
| ID: mdl-18719749
ABSTRACT
OBJECTIVE:
To evaluate the safety and effectiveness of trabeculectomy with mitomycin C in the management of childhood glaucoma.INTRODUCTION:
The use of antifibrotic agents enhances the success of trabeculectomy performed in both adults and children.METHODS:
A retrospective chart review (1991-2001) of 114 patients (114 eyes) from 0-14 years of age with congenital or developmental glaucoma. These patients underwent trabeculectomy with mitomycin but had not been previously treated with any antifibrotic agent.RESULTS:
The mean patient age was 57.36+/-51.14 months (range 0.5-168 months). Treatment was considered successful in 63 eyes (55.26%), with a mean intraocular pressure of 12.11+/-3.98 mmHg. For patients categorized as successfully treated, the mean follow-up time was 61.16+/-26.13 months (range 12-113 months). A post-surgical intraocular pressure of <16 was observed in 47 eyes. The life-table success rates for intraocular pressure control at 24, 36, 48, and 60 months were 90.2%, 78.7%, 60.7% and 50.8%, respectively. The cumulative probability of failure was 40.8% at 12 months. Following surgery, endophthalmitis appeared in eight eyes (4.88%) after an average 36.96 months (range 1.7-106 months). Other complications included expulsive hemorrhage, flat anterior chamber and bleb leak.DISCUSSION:
It has been reported in pediatric patients that trabeculectomy without adjunctive antimetabolites achieves a successful outcome in 30% to 50% of cases. In our study, treatment was considered successful in 63 eyes (55.26%) within 61.16+/-26.13 months of follow-up.CONCLUSIONS:
Trabeculectomy with mitomycin is safe and effective for short-term or long-term treatment of congenital or developmental glaucoma. The frequency of bleb-related endophthalmitis was no higher in these patients than that described in adults.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Trabeculectomia
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Glaucoma
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Mitomicina
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Antibióticos Antineoplásicos
Tipo de estudo:
Etiology_studies
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Evaluation_studies
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Observational_studies
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Prognostic_studies
/
Risk_factors_studies
Limite:
Adolescent
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Child
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Child, preschool
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Female
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Humans
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Infant
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Male
Idioma:
En
Revista:
Clinics (Sao Paulo)
Assunto da revista:
MEDICINA
Ano de publicação:
2008
Tipo de documento:
Article
País de afiliação:
Brasil