Review on the Management of Primary Congenital Glaucoma

Abstract

Despite being documented in medical history from over 2400 years ago, primary congenital glaucoma (PCG), being a disease with low incidence rate, remains a challenge to ophthalmologists.The article provides a broad overview on the pathophysiology and diagnostic approach to PCG with major emphasis on the treatment options of PCG. While reviewing on the well-established treatment options, namely goniotomy, trabeculo-tomy and combined trabeculotomy-trabeculectomy, emphasis has also been made to recent updates on secondary treatments: trabeculectomy, antimetabolites, glaucoma-drainage devices and cyclodestructive procedures.It is, however, important to note that the rarity of PCG places limitations on study design, most studies are, thus, retrospective, nonrandomized and have different definitions of surgical success. Ophthalmologists need to interpret the results with critical thinking and formulate individual treatment plans for each patient.How to cite this article: Yu Chan JY, Choy BNK, Alex LK Ng, Shum JWH. Review on the Management of Primary Congenital Glaucoma. J Curr Glaucoma Pract 2015;9(3):92-99.

Trabeculotomy versus combined trabeculotomy–trabeculectomy for primary congenital glaucoma: study protocol of a randomised controlled trial

“…IOP: IOP will be measured with a Tono-Pen Avia (Reichart, Depew, New York, USA) under sedation with chloral hydrate 10% and topical anaesthesia. Although the use of anaesthetic agents during examination under anaesthesia may influence IOP and affect the accuracy of IOP documentation, chloral hydrate has been shown to have a minimal effect on IOP in paediatric ophthalmic examinations 18…”

“…The horizontal corneal diameter (HCD) is typically increased in patients with PCG, which serves as an indication for disease severity and a key factor for surgery selection 188.…”

Pediatric ocular nanomedicines: Challenges and opportunities

“…Primary congenital glaucoma is an eye disease that results in elevated intraocular pressure, damage to the optic nerve, and risks of vision loss resulting from “cupping” (enlargement of optic cup) [6–8]. Typically diagnosed within the first year of life, the occurrence of primary congenital glaucoma is predicted in approximately 1 out of every 10,000 births within the United States alone.…”

Primary Congenital Glaucoma;

“…The contraindication of goniotomy is cloudy cornea as compared to trabeculectomy which can be performed in complicated cases. 7 Trabeculectomy is relatively an easier and conventional process, not requiring much expertise. There are two kinds, conventional trabeculectomy and modified trabeculectomy.…”