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The authors report the largest retrospective study of surgical results of goniotomoy and trabeculectomy for 42 patients (46 eyes) with glaucoma associated with Sturge-Weber syndrome (SWS). There were 18 males and 24 females, and 62 goniotomy procedures (51 goniotomy surgery, 11 trabeculectomy surgery and two eyes had both). Age at surgery was 1.5 years (one month – 23 years) and average IOP preop was 35mmHg (25-50). Ninety-eight percent (45 eyes) failed to achieve successful control of IOP. The average postop interval to failure was four months (one to 48). Further surgery included trabeculectomy filtration surgery for 19, glaucoma drainage implant placement for nine and cyclocryotherapy for four. The authors now recommend initial medical treatment for patients of all ages with glaucoma associated with SWS. For early onset glaucoma, they undertake goniosurgery combined with medical treatment and tube surgery is considered if added surgery is needed. The authors’ preference is for trabeculectomy surgery as an initial surgery for patients older than one year with secondary tube surgery at the site of failed trabeculectomy, if this fails.

Failure of goniosurgery for glaucoma associated with Sturge-Weber syndrome.
Yeung HH, Kana SA, Turlapati N, et al.
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Fiona Rowe (Prof)

Institute of Population Health, University of Liverpool, UK.

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