Surgical approaches to juvenile open-angle glaucoma

PURPOSE: To present the surgical options and surgical outcomes of juvenile open-angle glaucoma (JOAG).


METHODS: A retrospective review of the case series with JOAG that had undergone surgical treatment was undertaken. Sur-gical techniques, patient characteristics, and surgical outcomes were analyzed.
RESULTS: Thirteen eyes from eight patients with the diagnosis of JOAG were included in the study. The mean age was 26.77 ± 9.83 years. Five (62.5%) of the patients were male. The distribution of the operations was as follows: deep sclerectomy and external suture trabeculotomy in one eye (8%); Ahmed glaucoma valve implantation in one eye (8%); trabeculectomy with antimetabolite augmentation in five eyes (38%); and gonioscopy-assisted transluminal trabeculotomy (GATT) in six eyes (46%). The preoperative mean intraocular pressure (IOP) was 27.62 ± 7.17 mmHg, which decreased to 17.62 ± 13.06 mmHg at the last follow-up visit (36.21% decrease, P = 0.023, Wilcoxon rank test). IOP control was achieved without any additional surgical intervention in 10 (76.9%) eyes over the mean of 15.62 ± 12.17 months of the follow-up period. Further glaucoma surgery was required in three eyes, of which two had undergone GATT and one had undergone trabeculectomy as the primary surgery.
CONCLUSION: The surgical treatment of JOAG results in IOP reduction, and more than one surgery may be required in some cases.