Observation on the early efficacy of trabeculectomy combined with incision of outer wall of Schlemm’s canal for the treatment of juvenile glaucoma

Abstract

Objective To observe the early efficacy of trabeculectomy combined with incision of outer wall of Schlemm’s canal in the treatment of juvenile glaucoma. Methods The clinical data of 34 eyes of 22 cases with juvenile glaucoma from Sep.2016 to Feb.2019 in the First Affiliated Hospital of Zhengzhou University were retrospectively analyzed.All patients underwent trabeculectomy combined with incision of outer wall of Schlemm’s canal.The followed-up times was 6 months. Results There was no significant difference in visual acuity (logMAR) between before and after operation (t=-0.544, P=0.590). The average IOP decreased at each time point postoperatively, and the difference was statistically significant between before and after operation (P<0.05). Functional filtration blebs were formed in 21 eyes (61.76%) postoperatively.The complete success was in 27 eyes (79.41%) at 6 months postoperatively, and the partial success was in 4 eyes (11.76%). The success rate was 91.17%(31/34). At 1 day postoperatively, the intraocular pressure was ≤21 mmHg in 34 eyes (1 mmHg=0.133 kPa). The intraocular pressure increased at 1 month postoperatively in 3 eyes.After treatment with ocular hypotensive drugs, IOP of them decreased to normal level.At 6 months postoperatively, the IOP increased in 7 eyes and decreased after treatment with ocular hypotensive drugs.There were 3 eyes with further visual field impairment and cup-to-disk ratio damage among 7 eyes.No serious complication during or after surgery occurred. Conclusion Trabeculectomy combined with incision of outer wall of Schlemm’s canal for the treatment of juvenile glaucoma can effectively control the IOP and protect visual function. Key words: Glaucoma, juvenile; Trabeculectomy; Incision, outer wall, Schlemm’s canal