Goniosurgery does not yield long-term IOP control for pediatric Sturge-Weber glaucoma

Goniosurgery does not yield long-term IOP control for pediatric Sturge-Weber glaucoma


Glaucoma, Pediatric Ophth/Strabismus


This 28-year retrospective chart review reports the outcomes of goniosurgery for children with glaucoma associated with Sturge-Weber syndrome.

Study design

Researchers assessed 46 eyes of 42 patients who underwent initial goniosurgery for Sturge-Weber glaucoma. Surgeons performed 62 goniosurgical procedures; 51 were goniotomy and 11 were trabeculotomy. Outcomes included complete and qualified success rates and time to failure.

Outcomes

Goniosurgery (goniotomy or trabeculotomy) did not appear to yield long-term IOP control in Sturge-Weber glaucoma. Forty-five eyes failed to obtain IOP control (IOP>22 mmHg) or required additional glaucoma surgery with an average time to failure of 4 months. Only 1 eye achieved qualified success (i.e., IOP control requiring glaucoma medications).

Limitations

The study is a retrospective chart review, but given the rarity of Sturge-Weber glaucoma, it would be difficult to perform a prospective study with as many patients that are included here.

Clinical significance

These findings show goniosurgery does not offer long-term IOP control in Sturge-Weber glaucoma. Goniosurgery may be used as a temporizing procedure, but most eyes with Sturge-Weber glaucoma will require trabeculectomy or glaucoma drainage device placement to obtain IOP control.