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Efficacy and safety of trabeculectomy with mitomycin C for childhood glaucoma: a study of results with long-term follow-up.

Giampani J, Borges-Giampani AS, Carani JC, Oltrogge EW, Susanna R - Clinics (Sao Paulo) (2008)

Bottom Line: 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).In our study, treatment was considered successful in 63 eyes (55.26%) within 61.16+/-26.13 months of follow-up.

View Article: PubMed Central - PubMed

Affiliation: Department of Ophthalmology, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil. jgiampani@ig.com.br

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.

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Related in: MedlinePlus

Cumulative proportion of successΨΨ Number of patients at risk for failure at each time interval: 56 (at 24 months), 48 (at 36 months), 41 (at 48 months), 33 (at 60 months), 23 (at 72 months), 12 (at 84 months), 6 (at 96 months), 1 (at 108 months) and 0 (at 120 months).
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f1-cln63_4p0421: Cumulative proportion of successΨΨ Number of patients at risk for failure at each time interval: 56 (at 24 months), 48 (at 36 months), 41 (at 48 months), 33 (at 60 months), 23 (at 72 months), 12 (at 84 months), 6 (at 96 months), 1 (at 108 months) and 0 (at 120 months).

Mentions: The cumulative probabilities of success (Kaplan-Meier plot) for one eye of each patient were 90.2% at 24 months, 78.7% at 36 months, 60.7% at 48 months and 50.8% at 60 months (Figure 1).


Efficacy and safety of trabeculectomy with mitomycin C for childhood glaucoma: a study of results with long-term follow-up.

Giampani J, Borges-Giampani AS, Carani JC, Oltrogge EW, Susanna R - Clinics (Sao Paulo) (2008)

Cumulative proportion of successΨΨ Number of patients at risk for failure at each time interval: 56 (at 24 months), 48 (at 36 months), 41 (at 48 months), 33 (at 60 months), 23 (at 72 months), 12 (at 84 months), 6 (at 96 months), 1 (at 108 months) and 0 (at 120 months).
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC2664114&req=5

f1-cln63_4p0421: Cumulative proportion of successΨΨ Number of patients at risk for failure at each time interval: 56 (at 24 months), 48 (at 36 months), 41 (at 48 months), 33 (at 60 months), 23 (at 72 months), 12 (at 84 months), 6 (at 96 months), 1 (at 108 months) and 0 (at 120 months).
Mentions: The cumulative probabilities of success (Kaplan-Meier plot) for one eye of each patient were 90.2% at 24 months, 78.7% at 36 months, 60.7% at 48 months and 50.8% at 60 months (Figure 1).

Bottom Line: 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).In our study, treatment was considered successful in 63 eyes (55.26%) within 61.16+/-26.13 months of follow-up.

View Article: PubMed Central - PubMed

Affiliation: Department of Ophthalmology, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil. jgiampani@ig.com.br

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.

Show MeSH
Related in: MedlinePlus