Efficacy of Primary Trabeculectomy for Childhood Glaucoma: A Study of Results with 5 Year Follow -Up

Pham Thi Thuy Tien MD., Trang Thanh Nghiep MD., Mai Dang Tam MD., Nguyen Ngoc Anh MD.

Purposes: To evaluate the effectiveness of primary trabeculectomy in management of childhood glaucoma and the risk factors affected the success of this surgery.

Methods: The 5 year prospective study of 69 patients (106 eyes) from 0-14 years of age with congenital or development glaucoma at Eye Hospital Ho Chi Minh City from 2004 to 2008. These patients were performed primary trabeculectomies without using antifibrotic agents.

Results: The mean follow-up time was 54.83 ± 36.66 months with a range of 12-192 months. Fifty five eyes (53.8%) were considered successfully treated in which 44 eyes (41.5%) were absolute successes. The failure rate was 46.2% (49 eyes). Life table analysis identified that the success rates for intraocular pressure control at 12, 24, 36, 48 and 60 months were 72%, 64%, 54%, 43%, 31%, respectively. Cox' regression analyses showed that younger age at surgery and glaucomatous eyes having CDR over 0.7 were more likely to manage IOP unsuccessfully with hazard ratio 0,70 (p=0,033) and 1,97 (p=0,023), respectively.

Conclusions: The rate of success of primary trabeculectomy in childhood glaucoma was not high. The patient age at the time of surgery and severity of the disease were proved to be the major risk factors for primary trabeculectomy.

Key word: primary trabeculectomy.