Abstract：
OBJECTIVE: To report on the outcome of subsequent interventions after failed initial intervention for primary congenital glaucoma (PCG).
METHODS: Retrospective chart review of children presenting with PCG and failed the initial glaucoma surgery in Alexandria Main University Hospital from 2005 to 2017. The data included demographics, preoperative, operative and postoperative clinical characteristics. Success was defined as IOP<16mmHg and <20% from the presenting IOP and C/D ratio like or better than presentation.
RESULTS: The charts of 531 (260 right, 49%) eyes of 360 (224 males, 62%) children presenting with PCG and failed the initial glaucoma surgery (58 [31 right, 53%] eyes [10.9%] of 50 [28 males, 56%] children) revealed that at initial presentation, the mean±standard deviation (range, median) of the age of the children subjected to one successful glaucoma procedure and the study children was 8.6±11.7 (0.6-109, 5.2) and 4.9±6.1 (0.5-34.4, 3.0) months, respectively. Each of the study eyes was subjected to 2.6±0.8 (2-5.2) glaucoma procedures. The mean±standard deviation (range, median) duration between the initial and second glaucoma surgery and the duration of follow-up was 6.9±7.8 (0.7-39,3.9) and 61.5±32.1 (12.0-139.1, 60.1) months, respectively. At the final follow-up visit success was reported in 41 (70.1%) eyes by IOP<16mmHg criterion, 39 (67.2%) eyes by IOP>20% reduction criterion and in 28 (out of 35 eyes, 80.0%) by the optic nerve condition (C/D ratio) criterion. Success by all 3 criteria was reported in 25 (out of 35 eyes, 71%) eyes.
CONCLUSIONS: A repeat glaucoma surgical procedure maybe needed in up to 11% of operated PCG eyes, with the subsequent glaucoma surgical procedures being successful by about 70%.
METHODS: Retrospective chart review of children presenting with PCG and failed the initial glaucoma surgery in Alexandria Main University Hospital from 2005 to 2017. The data included demographics, preoperative, operative and postoperative clinical characteristics. Success was defined as IOP<16mmHg and <20% from the presenting IOP and C/D ratio like or better than presentation.
RESULTS: The charts of 531 (260 right, 49%) eyes of 360 (224 males, 62%) children presenting with PCG and failed the initial glaucoma surgery (58 [31 right, 53%] eyes [10.9%] of 50 [28 males, 56%] children) revealed that at initial presentation, the mean±standard deviation (range, median) of the age of the children subjected to one successful glaucoma procedure and the study children was 8.6±11.7 (0.6-109, 5.2) and 4.9±6.1 (0.5-34.4, 3.0) months, respectively. Each of the study eyes was subjected to 2.6±0.8 (2-5.2) glaucoma procedures. The mean±standard deviation (range, median) duration between the initial and second glaucoma surgery and the duration of follow-up was 6.9±7.8 (0.7-39,3.9) and 61.5±32.1 (12.0-139.1, 60.1) months, respectively. At the final follow-up visit success was reported in 41 (70.1%) eyes by IOP<16mmHg criterion, 39 (67.2%) eyes by IOP>20% reduction criterion and in 28 (out of 35 eyes, 80.0%) by the optic nerve condition (C/D ratio) criterion. Success by all 3 criteria was reported in 25 (out of 35 eyes, 71%) eyes.
CONCLUSIONS: A repeat glaucoma surgical procedure maybe needed in up to 11% of operated PCG eyes, with the subsequent glaucoma surgical procedures being successful by about 70%.
摘要：
目的：报告原发性先天性青光眼（PCG）初始干预失败后后续干预的结果。
方法：回顾性分析2005年至2017年亚历山大大学附属医院首次青光眼手术失败的PCG患儿。数据包括人口统计，术前,手术和术后临床特点。成功定义为IOP<16mmHg和<20％，来自呈现的IOP和C/D比率相似或优于呈现。
结果：531的图表（260右，49%）的眼睛360（224名男性，62％）出现PCG且初次青光眼手术失败的儿童（58[31右，53％的眼睛[10.9％]50[28名男性，56%]儿童)在初次陈述时透露，平均值±标准偏差(范围，中位数）接受一次成功青光眼手术的儿童的年龄为8.6±11.7（0.6-109，5.2）和4.9±6.1（0.5-34.4，3.0）个月，分别。对每只研究眼睛进行2.6±0.8(2-5.2)青光眼手术。平均值±标准偏差(范围，初次和第二次青光眼手术和随访时间之间的中位数）分别为6.9±7.8（0.7-39,3.9）和61.5±32.1（12.0-139.1,60.1）个月，分别。在最后一次随访时，根据IOP<16mmHg标准，41只(70.1%)眼睛报告成功。根据IOP>20%的降低标准，39只(67.2%)眼和28只(35只眼中，80.0％）按视神经状况（C/D比）标准。所有3个标准的成功报告有25个（35只眼睛中，71%)的眼睛。
结论：可能需要在高达11％的手术性PCG眼进行重复青光眼手术，随后的青光眼手术成功率约为70％。
方法：回顾性分析2005年至2017年亚历山大大学附属医院首次青光眼手术失败的PCG患儿。数据包括人口统计，术前,手术和术后临床特点。成功定义为IOP<16mmHg和<20％，来自呈现的IOP和C/D比率相似或优于呈现。
结果：531的图表（260右，49%）的眼睛360（224名男性，62％）出现PCG且初次青光眼手术失败的儿童（58[31右，53％的眼睛[10.9％]50[28名男性，56%]儿童)在初次陈述时透露，平均值±标准偏差(范围，中位数）接受一次成功青光眼手术的儿童的年龄为8.6±11.7（0.6-109，5.2）和4.9±6.1（0.5-34.4，3.0）个月，分别。对每只研究眼睛进行2.6±0.8(2-5.2)青光眼手术。平均值±标准偏差(范围，初次和第二次青光眼手术和随访时间之间的中位数）分别为6.9±7.8（0.7-39,3.9）和61.5±32.1（12.0-139.1,60.1）个月，分别。在最后一次随访时，根据IOP<16mmHg标准，41只(70.1%)眼睛报告成功。根据IOP>20%的降低标准，39只(67.2%)眼和28只(35只眼中，80.0％）按视神经状况（C/D比）标准。所有3个标准的成功报告有25个（35只眼睛中，71%)的眼睛。
结论：可能需要在高达11％的手术性PCG眼进行重复青光眼手术，随后的青光眼手术成功率约为70％。
