Mittel- und langfristige Ergebnisse nach Trabekulotomie bei Patienten mit juvenilen und spatjuvenilen Offenwinkelglaukomen

Background: To determine success rate of trabeculotomy in patients with juvenile and late-juvenile glaucoma in a retrospective study. Patients and Methods: 46 eyes of 41 juvenile glaucoma-patients (24 female, 17 male) were submitted to trabeculotomy during the period of 1980-1997. Patients age at the time of surgery was 30.2 ± 10.5 years (11-49 years, median 21 years). Follow-up time was 35 ± 46 months (1-155 months). Results: Median preoperative visual acuity was 1.0 (range 0.002 to 1.25), postoperative visual acuity at the end of the follow up period was 0.8 (median) with a range from 0.002 to 1.2. In all patients preoperative intraocular pressure was elevated and a glaucomatous configuration of the optic disc was noticed. Preoperative intraocular pressure (IOP) ranged from 30.5 ± 13.2 mm Hg, after surgery IOP was 16.2 ± 5 mm Hg. Mean decrease of the IOP postoperatively was 54.4%. In 37% of the eyes IOP was lower than 23 mm Hg without additional medication, in 47% of the eyes IOP was lower than 23 mm Hg with additional medication. In 8 eyes additional antiglaucoma-surgery was necessary. After a follow-up time of 60 months 81% of the patients (n = 37 eyes) had an IOP below 23 mm Hg, after 120 months in 80% of the patients (n = 29 eyes) IOP was below 23 mm Hg. Conclusion: The success rate of trabeculotomy (defined as the ability to lower intraocular pressure lower than 23 mm Hg with or without antiglaucoma medication) in our patients is 84%. After second operation, success rate is 89%. Trabeculotomy for patients with juvenile open angle glaucoma is a safe procedure and avoids problems and complications of filtering procedures.