Congenital glaucoma: Intraocular pressure and visual prognosis after trabeculectomy and functional rehabilitation for amblyopia

The goal of our work is to analyze the clinical aspects, study the change in intraocular pressure and functional prognosis after trabeculectomy and amblyopia treatment of children followed for congenital glaucoma. The present study is a retrospective study including 86 patients (143 eyes) followed over a period from March 2009 to September 2015. The median age at diagnosis was 6 months. The mean intraocular pressure was 25±5mmHg preoperatively and 11.6±4mmHg at the conclusion. The average initial cup was 0.5. Trabeculectomy was performed in all cases. Twelve eyes were operated twice. After a follow-up of 4 years, normalization of the intraocular pressure was obtained in 35% after the first surgery, in 44% on mono or dual therapy, in 10% after a surgical revision. Cycloplegic refraction was performed; myopia was found in 55% of cases, the mean was -6.5 diopters. 20% of children were hyperopic with a mean of 2.5D. A mean 2D of astigmatism was found in 60 eyes (42%). Anisometropia was present in 10 children. Corrected visual acuity was quantified in 37% of children. The mean was 2/10±3 initially and 4/10 at the conclusion. It was≥4/10 in 41% of cases and≤1/10 in 56%. Unilateral amblyopia was found in 40% of the children. Seventy percent of the patients had strabismus. This study highlights the need for prolonged treatment of amblyopia in congenital glaucoma to achieve the best possible visual recovery.