• Glaucoma, Pediatric Ophth/Strabismus

    Review of: Failure of Goniosurgery for Glaucoma Associated With Sturge-Weber Syndrome

    Yeung H, Kane S, Turlapati N, et al. Journal of Pediatric Ophthalmology and Strabismus, November 2020

    This 28-year retrospective chart review reports the outcomes of goniosurgery for children with glaucoma associated with Sturge-Weber syndrome.

    Study design

    Researchers assessed 46 eyes of 42 patients who underwent initial goniosurgery for Sturge-Weber glaucoma. Surgeons performed 62 goniosurgical procedures; 51 were goniotomy and 11 were trabeculotomy. Outcomes included complete and qualified success rates and time to failure.

    Outcomes

    Goniosurgery (goniotomy or trabeculotomy) did not appear to yield long-term IOP control in Sturge-Weber glaucoma. Forty-five eyes failed to obtain IOP control (IOP>22 mmHg) or required additional glaucoma surgery with an average time to failure of 4 months. Only 1 eye achieved qualified success (i.e., IOP control requiring glaucoma medications).

    Limitations

    The study is a retrospective chart review, but given the rarity of Sturge-Weber glaucoma, it would be difficult to perform a prospective study with as many patients that are included here.

    Clinical significance

    These findings show goniosurgery does not offer long-term IOP control in Sturge-Weber glaucoma. Goniosurgery may be used as a temporizing procedure, but most eyes with Sturge-Weber glaucoma will require trabeculectomy or glaucoma drainage device placement to obtain IOP control.