| Popis: |
Childhood glaucomas represent a diagnostic and therapeutic challenge for both ophthalmologists and glaucoma specialists, not only because achieving intraocular pressure (IOP) control is difficult but also because some patients may still have poor vision in spite of successful IOP control due to amblyopia, corneal opacities, and/or uncorrected high myopia and astigmatism. Medical treatment is only used adjunctively to reduce intraocular pressure (IOP), but the mainstay of treatment is surgical management [1, 2]. All cases of primary congenital glaucoma require surgical treatment, and although angular surgery (goniotomy or trabeculotomy) has been the preferred first procedure, glaucoma drainage devises (GDD) have a leading role in refractory cases and are even preferred as a first surgical effort in selected cases where other surgeries are contraindicated or unlikely to succeed (i.e., when there is significant conjunctival scarring) [3–10]. Furthermore it has been found that 20% of children with glaucoma often require two or more surgical procedures for an adequate IOP control, and GDD are frequently used in the second or third surgical attempt [3]. |
