Our Summary

This study looked at how effective a surgical procedure called goniotomy is at treating childhood glaucoma in Indian children. The researchers analyzed data from all the young glaucoma patients who had this surgery at a single center in Northwest India from July 2017 to June 2020. The surgery was performed either as a first treatment or as a second attempt if the initial surgery didn’t work.

The results showed that out of 172 eyes from 126 children who had the surgery, the procedure was successful in reducing eye pressure to acceptable levels in about 80% of cases for Primary Congenital Glaucoma (a type of childhood glaucoma) when it was the first surgery, and in about 68% of cases when it was a redo surgery. For other types of glaucoma, the success rate was around 62%.

Interestingly, the surgery was most successful in children with lower starting eye pressure and smaller eye size. A year after the surgery, half of the patients had good vision, almost 30% had moderate vision, and 20% had severe vision impairment. Importively, there were no significant complications during or after the surgery.

The study concluded that goniotomy is an effective and less invasive way to treat childhood glaucoma, making it a good option for these patients.

FAQs

  1. What is the success rate of goniotomy surgery in treating Primary Congenital Glaucoma in Indian children?
  2. What factors were found to make the goniotomy surgery more successful in children?
  3. Were there any significant complications reported during or after the goniotomy surgery in the study?

Doctor’s Tip

A doctor might advise a patient undergoing glaucoma surgery to follow post-operative care instructions carefully, including using prescribed eye drops, attending follow-up appointments, and avoiding strenuous activities. They may also recommend regular eye exams to monitor eye pressure and overall eye health. It’s important to communicate any changes in vision or symptoms to your doctor promptly.

Suitable For

Overall, glaucoma surgery, including goniotomy, may be recommended for patients with glaucoma who have not responded well to other treatments such as eye drops or laser therapy. In particular, goniotomy may be a good option for children with primary congenital glaucoma or other types of glaucoma that are not well controlled with other treatments. It may be especially effective in patients with lower starting eye pressure and smaller eye size. Ultimately, the decision to recommend glaucoma surgery will depend on the individual patient’s specific condition and needs, and should be made in consultation with an ophthalmologist or eye surgeon.

Timeline

  • Before glaucoma surgery: The patient may have been diagnosed with glaucoma and tried other treatments such as eye drops to lower eye pressure. If these treatments were not effective, the patient may have been recommended for surgery. The patient would have undergone pre-operative evaluations and tests to determine if they are a suitable candidate for the surgery.

  • During glaucoma surgery: The patient would have undergone the goniotomy procedure, which involves creating a small opening in the eye’s drainage system to improve the flow of fluid and lower eye pressure. The surgery is typically done under local anesthesia and is a relatively quick procedure.

  • After glaucoma surgery: The patient would have been monitored closely in the immediate post-operative period for any complications or side effects. The patient would have been prescribed eye drops and medications to prevent infection and manage inflammation. Follow-up appointments would have been scheduled to monitor the patient’s eye pressure and vision over time.

Overall, the patient may experience improved vision and reduced eye pressure following successful glaucoma surgery, leading to better long-term outcomes and quality of life.

What to Ask Your Doctor

Some questions a patient should ask their doctor about glaucoma surgery include:

  1. What are the potential risks and complications associated with goniotomy surgery for glaucoma?
  2. What is the success rate of goniotomy surgery for treating childhood glaucoma, particularly in my specific case?
  3. How long is the recovery period after goniotomy surgery, and what can I expect during the recovery process?
  4. Will I need to take any medications or follow any specific post-operative care instructions after the surgery?
  5. Are there any alternative treatment options for my child’s glaucoma that I should consider?
  6. How often will follow-up appointments be necessary after the surgery, and what will be monitored during these appointments?
  7. What are the long-term outcomes and prognosis for a child who undergoes goniotomy surgery for glaucoma?
  8. Are there any lifestyle changes or precautions that my child should take after the surgery to protect their eye health?
  9. How experienced is the surgical team in performing goniotomy procedures, and what is the success rate at your facility?
  10. Are there any specific factors or characteristics about my child’s case that may affect the outcome of the surgery, and how will these be taken into consideration during the treatment process?

Reference

Authors: Kaushik S, Gupta G, Thattaruthody F, Dhingra D, Kumari K, Arora A, Snehi S, Raj S, Pandav SS. Journal: Indian J Ophthalmol. 2021 Aug;69(8):2088-2094. doi: 10.4103/ijo.IJO_3305_20. PMID: 34304184