Filtrated surgery – viscosinusotrabeculotomy of congenital glaucoma associated with Sturge-Weber-Krabbe syndrome

Abstract

Introduction: The problem of increasing efficiency of congenital glaucoma surgery in pediatrics is extremely relevant. Complicated glaucoma and its treatment in patients with Sturge-Weber-Krabbe (S/W/K) syndrome due to its rare occurrence not well described in modern literature. Material and methods: 13 children (26 eyes) aged from 2 months to 17y.o. average (56,2 ± 66,3m.o.) with S/W/K syndrome were carried out full ophthalmological examination & filtrated surgery of congenital glaucoma on 7 eyes. The item - to work out the features of clinical features & filtrative congenital glaucoma surgery in children with S/W/K syndrome. Results: Nevus flammeus observed in all children: in 8 cases it was on one side of the face, in 5 cases – on both. Glaucoma was diagnosed in 11 children – on 8 eyes it was monocular on the nevus side, in 3 cases (6 eyes) binocular in binocular nevus cases. All children at the beginning were treated by hypotensive eye drops instillation. Intraocular pressure (IOP) normalization on 5 eyes. 7 eyes were operated by the new elaborated technique of congenital glaucoma treatment – viscosinusotrabeculotomy (Bobrova NF et all, 2009). Elaborated technique in S/W/K syndromes additionally allowed to stop hemorrhage complications during operation. IOP were normalized after operation in all cases without complications. Stable hypotensive effect was observed for 2 years follow up. Conclusion: Dispersive viscoelastic (v/e) usage as temporary “liquid” implant allowed to separate mechanically surgically formed filtrate channel surfaces & reduce aseptic inflammation of operated tissues due to anti-inflammatory effect of hyaluronic acid, what in general allows to decrease the proliferative phase of connective tissue formation. Viscosinusotrabeculotomy is capable to create and save the new ways of liquid out facility & receive stable IOP compensation in long follow-up in congenital glaucoma cases in S/W/K syndrome.