TY - JOUR
T1 - Childhood glaucoma surgery in the 21st Century
AU - Papadopoulos, M.
AU - Edmunds, B.
AU - Fenerty, C.
AU - Khaw, P. T.
N1 - Funding Information:
Dr Beth Edmunds was supported by an unrestricted grant to OHSU from Research to Prevent Blindness. Professor Sir Peng Tee Khaw was supported in part by the NIHR Biomedical Research Centre Moorfields Eye Hospital and UCL Institute of Ophthalmology, Fight for Sight, Moorfields Special Trustees, Mr John Nolan, Henry Hadaway MBE and the Helen Hamlyn Trust in memory of Paul Hamlyn.
PY - 2014/8/14
Y1 - 2014/8/14
N2 - Most children with glaucoma will require surgery in their lifetime, often in their childhood years. The surgical management of childhood glaucoma is however challenging, largely because of its greater potential for failure and complications as compared with surgery in adults. The available surgical repertoire for childhood glaucoma has remained relatively unchanged for many years with most progress owing to modifications to existing surgery. Although the surgical approach to childhood glaucoma varies around the world, angle surgery remains the preferred initial surgery for primary congenital glaucoma and a major advance has been the concept of incising the whole of the angle (circumferential trabeculotomy). Simple modifications to the trabeculectomy technique have been shown to considerably minimise complications. Glaucoma drainage devices maintain a vital role for certain types of glaucoma including those refractory to other surgery. Cyclodestruction continues to have a role mainly for patients following failed drainage/filtering surgery. Although the prognosis for childhood glaucoma has improved significantly since the introduction of angle surgery, there is still considerable progress to be made to ensure a sighted lifetime for children with glaucoma all over the world. Collaborative approaches to researching and delivering this care are required, and this paper highlights the need for more high-quality prospective surgical trials in the management of the childhood glaucoma.
AB - Most children with glaucoma will require surgery in their lifetime, often in their childhood years. The surgical management of childhood glaucoma is however challenging, largely because of its greater potential for failure and complications as compared with surgery in adults. The available surgical repertoire for childhood glaucoma has remained relatively unchanged for many years with most progress owing to modifications to existing surgery. Although the surgical approach to childhood glaucoma varies around the world, angle surgery remains the preferred initial surgery for primary congenital glaucoma and a major advance has been the concept of incising the whole of the angle (circumferential trabeculotomy). Simple modifications to the trabeculectomy technique have been shown to considerably minimise complications. Glaucoma drainage devices maintain a vital role for certain types of glaucoma including those refractory to other surgery. Cyclodestruction continues to have a role mainly for patients following failed drainage/filtering surgery. Although the prognosis for childhood glaucoma has improved significantly since the introduction of angle surgery, there is still considerable progress to be made to ensure a sighted lifetime for children with glaucoma all over the world. Collaborative approaches to researching and delivering this care are required, and this paper highlights the need for more high-quality prospective surgical trials in the management of the childhood glaucoma.
UR - http://www.scopus.com/inward/record.url?scp=85044561230&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85044561230&partnerID=8YFLogxK
U2 - 10.1038/eye.2014.140
DO - 10.1038/eye.2014.140
M3 - Review article
C2 - 24924446
AN - SCOPUS:85044561230
VL - 28
SP - 931
EP - 943
JO - Transactions of the Ophthalmological Societies of the United Kingdom
JF - Transactions of the Ophthalmological Societies of the United Kingdom
SN - 0950-222X
IS - 8
ER -