Type of Surgery
Information
Last updated: 02/17/2009
The congenital glaucomas affect 1: 10,000 infants, with boys affected twice as often as girls. Both eyes are affected in 75% of patients. These glaucomas are differentiated from the secondary glaucomas caused by such medical conditions as juvenile...
rheumatoid arthritis (JRA), Marfan's syndrome, or diabetes; or caused by intraocular tumors, cataract surgery, or trauma. Many of the secondary glaucomas respond better to medical treatment than to surgical treatment. Ninety-five percent of developmental or congenital glaucoma appears before age three. Another type of pediatric glaucoma is usually diagnosed between ages 10 and 35 and resembles the type of glaucoma seen in adults more closely than the congenital glaucomas, although some developmental anomalies may be present. This type of glaucoma is referred to as juvenile-onset open angle glaucoma (JOAG).
Congenital glaucoma is a polygenic disorder; that is, it involves more than one gene. Since this type of glaucoma is inherited and the genes for JOAG and congenital glaucoma have been mapped, genetic testing is available to determine whether a specific child is at risk for these disorders.
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Goniotomy is a surgical procedure in which the doctor uses a lens called a goniolens to see the structures of the front part of the eye (anterior chamber). An opening is made in the trabecular meshwork, the group of tiny canals located in the drainage angle, where fluid leaves the eye. The new opening provides a way for fluid to flow out of the eye. Goniotomy is a surgery for children only.
Goniotomy is used to treat congenital glaucoma if the clear covering (cornea) over the iris, the colored part of the eye, is not cloudy.
Other Information
Approximately 56% of all patients achieve results of 20/20 or better and over 90% achieve 20/40 or better (which is good enough to drive without corrective lenses in most regions).1 Those with moderate to high myopia (greater than 7 diopters) have a lesser chance of achieving that result. As technique and technology improve, the results continue to improve.
From: Eye Surgery Education Council
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