Journal of Ophthalmic & Vision Research, Vol 2, No 1 (2007)

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Primary Single-Plate Molteno Implant for Pediatric Glaucoma Associated with Sturge-Weber Syndrome

Heydar Amini, Mohammad-Reza Razeghinejad, Bahare Esfandiarpour

Abstract


PURPOSE: To evaluate the efficacy and safety of primary single-plate Molteno tube implantation for management of glaucoma in children with Sturge-Weber syndrome. METHODS: Primary single-plate Molteno tube implantation was performed in eyes of patients with Sturge-Weber syndrome aged < 17 years. Success was defined as intra-ocular pressure (IOP) higher than 22 mmHg with (relative success) or without (absolute success) antiglaucoma medications. Intra- and postoperative complications were also evaluated. RESULTS: Overall, nine eyes of seven patients with mean age of 9.6±3.7 (range 5-17) years were operated and followed for 32±4.7 (range 20-36) months. Mean IOP decreased from 34.2±8.3 mmHg preoperatively to 21.2±7.3 mmHg at final follow up (P=0.012). Mean number of antiglaucoma medications decreased from 3.4±0.5 preoperatively to 2.2±1.3 at final follow up (P=0.058). The cumulative probability of relative success was 97.2% (95% confidence interval [CI], 91.8-100%) at 12 months, 78.0% (95%CI, 60.4-95.7%) at 24 months and 43.3% (95%CI, 16.2-70.5%) at final follow up. Two eyes achieved absolute success during the first six months, however, at six months and later no eye achieved absolute success. No intraoperative complication occurred; postoperative complications included choroidal effusion necessitating drainage in three eyes (33.3%), and cataract formation and retinal detachment, each in one eye (11%). At final follow up, visual acuity remained unchanged in five eyes and deteriorated in four eyes. CONCLUSION: The outcomes of this small series revealed that primary single-plate Molteno tube implantation appears to be associated with limited success and a relatively high complication rate in pediatric glaucoma associated with Sturge-Weber syndrome.


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