To evaluate the long term surgical outcomes of children with primary congenital glaucoma (PCG) in a South Indian population.
This retrospective cohort study included children with PCG who have had surgery trabeculotomy, trabeculectomy, or combined trabeculotomy with trabeculectomy (CTT) as primary surgery from 1997-2000 at a tertiary eye center in India with minimum of 5 years of follow-up. Main outcome measures were intraocular pressure (IOP) control, glaucoma medication use, surgical success rates, and complications. Survival analyses were performed to determine cumulative probability of complete and qualified success.
The study included 50 eyes of 31 subjects. Mean age at initial surgery was 5 months (range, 5 days – 48 months) and 19 (61.3%) subjects had bilateral disease. Mean duration of follow-up was 10.9 ± 3.10 years (range, 6-18 years). Mean IOP reduced from 28.58 ± 9.78 mmHg (range, 10-59 mmHg) preoperatively to 17.13±7.62 mmHg postoperatively (range, 5-42 mmHg, p-value <0.001) at final follow up. Survival analysis showed that the probability of surgical success in CTT was 77.8% at 1 year, 66.2% at 2 years, 53.0% at 5 years, and 16.6% at 15 years. Visual acuity at last available follow up correlated with surgical success (p=0.042).
Surgical success after long term follow-up of children with PCG is low. The probability of surgical success declines over time. Children with PCG require life-long follow-up and management, even after initial surgical success, in order to prevent visual impairment and blindness.

Copyright © 2020. Published by Elsevier Inc.