RESUMEN
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Asunto(s)
Humanos , Sarcoidosis/diagnóstico , Histiocitosis de Células no Langerhans/diagnóstico , Factor de Necrosis Tumoral alfa/antagonistas & inhibidores , Diagnóstico DiferencialRESUMEN
PURPOSE: To evaluate the results and long-term complications of glaucoma drainage devices (GDD) in paediatric patients (0-15 years). METHODS: Retrospective cohort study was conducted on 17 implanted glaucoma drainage devices from July 1994 to April 2007 in 14 patients (17 eyes). In two patients (3 eyes) a Molteno GDD (MGDD) was implanted, and in 12 patients (14 eyes) an Ahmed GDD (AGDD) was used. We studied the demographic and glaucoma related patient data, as well as the probability of surgical success. The time which intraocular pressure (IOP) was controlled and the postoperative complications were also studied. RESULTS: Of the fourteen patients, 9 (64.28%) showed congenital glaucoma, and 5 (35.71%) aphakic glaucoma. The pre-aqueous drainage device median IOP was 29.82 mmHg (SD: 6.98), and 14.05 mmHg (SD: 7.57) postoperative. The median follow-up was 3.14 years (3 months-8.3 years). Success of aqueous drainage device was defined as an IOP less than 21 mmHg with or without medication on the last two follow-up visits, and without severe complications or further glaucoma surgery. Using a Kaplan Meier analysis there was success in 76%, 63% and 55% at the six months, 1-3 years and 4-8 years respectively. The GDD was a failure in 41.17%. CONCLUSIONS: GDDs are a good surgery option for refractory paediatric glaucoma when other surgery procedures have failed or have bad prognosti.
Asunto(s)
Implantes de Drenaje de Glaucoma , Glaucoma/cirugía , Adolescente , Niño , Preescolar , Estudios de Cohortes , Femenino , Implantes de Drenaje de Glaucoma/efectos adversos , Humanos , Lactante , Recién Nacido , Masculino , Implantes de Molteno/efectos adversos , Estudios Retrospectivos , Factores de Tiempo , Resultado del TratamientoRESUMEN
Propósito: Evaluar los resultados y complicaciones a largo plazo de los dispositivos de drenaje para glaucoma (DDG) en pacientes pediátricos (0-15 años). Material y métodos: Estudio retrospectivo de cohortes de 17 DDG implantadas desde julio de 1994 hasta abril del año 2007 en 14 pacientes (17 ojos). En dos pacientes (3 ojos) se implantó un DDG de Molteno (DDGM) y en 12 pacientes (14 ojos) un DDG de Ahmed (DDGA). Se han recogido datos demográficos y relacionados con la afección glaucomatosa de cada paciente. Se ha estudiado el porcentaje de éxito de la cirugía, así como el tiempo durante el cual se ha mantenido controlada la tensión desde el implante del dispositivo y las complicaciones derivadas de este. Resultados: De los 14 pacientes, nueve (64,28%) presentaban glaucoma congénito, y cinco (35,71%) glaucoma afáquico secundario a cirugía de catarata. La media de la presión intraocular (PIO) preoperatoria fue de 29,82mmHg (DS: 6,98). La media de la PIO posquirúrgica fue de 14,05 mmHg (DS: 7,57). La media del seguimiento ha sido de 3,14 años (3 meses-8,3 años). Se ha considerado como éxito mantener, en las dos últimas revisiones, la PIO igual o por debajo de 21mmHg sin signos de progresión de glaucoma con o sin uso de fármacos hipotensores tópicos, sin necesidad de cirugías de glaucoma adicionales y sin la aparición de complicaciones devastadoras para la visión. La probabilidad acumulada de éxito según el análisis de Kaplan Meier ha sido de 76, 63 y 55% a los 6 meses, 1-3 años y 4-8 años respectivamente. El 41,17% de los DDG fracasaron (7/17). Conclusiones: Los DDG son una buena opción quirúrgica para los glaucomas refractarios pediátricos cuando otros procedimientos quirúrgicos han fracasado o tienen un mal pronóstico(AU)
Purpose: To evaluate the results and long-term complications of glaucoma drainage devices (GDD) in paediatric patients (0-15 years). Methods: Retrospective cohort study was conducted on 17 implanted glaucoma drainage devices from July 1994 to April 2007 in 14 patients (17 eyes). In two patients (3 eyes) a Molteno GDD (MGDD) was implanted, and in 12 patients (14 eyes) an Ahmed GDD (AGDD) was used. We studied the demographic and glaucoma related patient data, as well as the probability of surgical success. The time which intraocular pressure (IOP) was controlled and the postoperative complications were also studied. Results: Of the fourteen patients, 9 (64.28%) showed congenital glaucoma, and 5 (35.71%) aphakic glaucoma. The pre-aqueous drainage device median IOP was 29.82mmHg (SD: 6.98), and 14.05mmHg (SD: 7.57) postoperative. The median follow-up was 3.14 years (3 months-8.3 years). Success of aqueous drainage device was defined as an IOP less than 21mmHg with or without medication on the last two follow-up visits, and without severe complications or further glaucoma surgery. Using a Kaplan Meier analysis there was success in 76%, 63% and 55% at the six months, 1-3 years and 4-8 years respectively. The GDD was a failure in 41.17%. Conclusions: GDDs are a good surgery option for refractory paediatric glaucoma when other surgery procedures have failed or have bad prognosti(AU)