Abstract

P 011

Trabeculotomy in childhoods’ glaucoma in anterior segment dysgenesis (Rieger syndrome)

Petkova N. 
University eye Clinic, Alexandrovska Hospital, Sofia, Bulgaria

Objective: To evaluate the efficacy and safety of trabeculotomy a modo Harms (TTH) in children, aged 10 months to 8 years, with anterior segment dysgenesis/Axenfeld-Rieger syndrome (ARS).
Methods: In total 13 eyes of 7 children with ARS with corneal diameter <13 mm in 5 eyes and >13 mm in 8 eyes., cup/disc ratio <0.3 in 3 eyes and >0.4 mm in all other eyes underwent TTH.Mean intraocular pressure /IOP/ before treatment was 32,4±4 mm Hg. Presurgical medication was with Cusimolol 0.5%, Azopt, or Fotil bid. IOP was measured before and after surgery. TTH was performed in all 13 eyes. Good IOP control <21 mm Hg was achieved in 6 eyes without additional medication and in 3 eyes with additional medication repeated TTH with trabeculectomy was performed in 4 eyes with corneal diameter >13 mm Hg.
Results: Mean IOP after surgical treatment was 18±2 mm Hg. Additional treatment with Betoptic S 0,25% was.needed in 50% of the eyes. Most common complication was transitory hyphaema. Transitory hypotony and shallow anterior chamber were observed predominantly after combined surgical procedures.
Conclusions: Glaucoma in anterior segment dysgenesis could be observed in early childhood. TTH could be performed successfully as first line treatment, but in more advanced cases combined surgical procedures with Trabeculectomy are recommended.

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