Surgical Outcomes of Combined Deep Sclerectomy With Trabeculotomy and Trabeculecomty With Trabeculotomy in Pediatric Glaucoma

摘要

Purpose: : To evaluate the outcomes of combined deep sclerectomy and trabeculotomy compared with trabeculectomy and trabeculotomy for pediatric glaucoma Methods: : A retrospective chart review of 27 eyes of 20 patients underwent combined deep sclerectomy and trabeculectomy and 18 eyes of 12 patients underwent combined trabeculectomy and trabeculotomy was done. IOP change, visual acuitiy, cumulative probabilities of surgical success ad postoperative complication were compared between two groups. Results: : The mean patient age was 11.29 ?± 4.24 / 14.11 ?± 4.69 (range 6~21 years/ 7~27years) for trabeculetomy group and deep sclerectomy group. Visual acuity was no significant change after operation in both group. (no statistic meaning. P0.005) IOP change showed successful result in both surgery group. Mean IOP was 24.25 ?± 9.04mmHg/15.65 ?± 4.84 mmHg for trabeculectomy group before surgery and 6 month after operation, 17.63 ?± 8.69mmHg/11.35 ?± 2.76mmHg for deep sclerectomy group. Pre and postoperative mean numbers of eyedrops for lowering IOP was 2 ?± 0.89 /1.53 ?± 0.94 for trabeculectomy group and 1.07 ?± 0.99/0.37 ?± 0.63 for deep sclerectomy group. Cumulative probabilities of surgical success at postoperative 12months were 95.6% in deep sclerectomy group and 92.3 % in trabeculectomy group. Postoperative 30months success rate was 95.6% in deep sclcerectomy group and 62.9% in trabeculectomy group. (p=0.63, Log rank) Conclusions: : Trabeculectomy with trabeculotomy and Deep sclerectomy with trabeculotomy can be effective surgical procedure for lowering IOP. But Deep sclerectomy with trabeculotomy showed higher success rate for long term period without complication or reoperation.