Surgical Management of Pediatric GlaucomaOu Y.a · Caprioli J.b
aGlaucoma Division, Department of Ophthalmology, University of California, San Francisco, Calif, bGlaucoma Division, Jules Stein Eye Institute, University of California, Los Angeles, Calif, USA Bettin P, Khaw PT (eds): Glaucoma Surgery. Dev Ophthalmol. Basel, Karger, 2012, vol 50, pp 157–172 (DOI:10.1159/000334798)
Pediatric glaucoma surgery is challenging because of the differences in anatomy from the adult, differences in the behavior of the tissues of a child’s glaucomatous eye, the variety in causes of the disease, and difficulties with postoperative management. Goniotomy and trabeculotomy are the preferred initial treatments for primary congenital glaucoma. Trabeculectomy with adjunctive mitomycin C is more likely to succeed in older, phakic patients, but carries the long-term risk of bleb-associated endophthalmitis. Glaucoma drainage devices may be preferred in younger children and in patients with aphakic glaucoma, but these devices can cause tube-related complications. Lastly, cyclodestructive procedures are reserved for patients in whom filtering surgery has failed, given its more unpredictable effects and serious complications.
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