Efficacy and safety of trabeculectomy with mitomycin C for childhood glaucoma: a study of results with long-term follow-up
| Autor: | Remo Susanna Junior, Jair Giampani Junior, Adriana Silva Borges-Giampani, José Carlos Eudes Carani, Ernst Werner Oltrogge |
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| Jazyk: | angličtina |
| Rok vydání: | 2008 |
| Předmět: |
Male
Intraocular pressure medicine.medical_specialty Complications Adolescent genetic structures Efficacy Long term follow up medicine.medical_treatment Mitomycin Glaucoma Trabeculectomy Childhood glaucoma Age Distribution Endophthalmitis Ophthalmology medicine Humans Child Intraocular Pressure Retrospective Studies lcsh:R5-920 Antibiotics Antineoplastic business.industry Research Mitomycin C Infant Retrospective cohort study General Medicine medicine.disease Combined Modality Therapy eye diseases Surgery Treatment Outcome Child Preschool Female lcsh:Medicine (General) business Follow-Up Studies |
| Zdroj: | Clinics, Volume: 63, Issue: 4, Pages: 421-426, Published: 2008 Clinics (Sao Paulo, Brazil) Clinics; v. 63 n. 4 (2008); 421-426 Clinics; Vol. 63 Núm. 4 (2008); 421-426 Clinics; Vol. 63 No. 4 (2008); 421-426 Clinics Universidade de São Paulo (USP) instacron:USP Clinics, Vol 63, Iss 4, Pp 421-426 (2008) |
| ISSN: | 1980-5322 1807-5932 |
| Popis: | 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. |
| Databáze: | OpenAIRE |
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