الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
The accurate assessment of congenital glaucoma progression is challenging in young children especially borderline cases. As IOP measurement is affected by many factors. Furthermore, optic disc evaluation and detection of progressive myopia may be hindered by corneal haze and perimetry is not possible in this age group. So additional useful parameters to confirm adequate postoperative IOP control would be helpful. IOP related complications like ocular enlargement and axial myopia in infant and young childhood glaucoma due to their thin elastic sclera have increased the interest in ocular biometry over the years due to the value of these parameters in clinical evaluation, decision making and assessing response to surgical intervention. In this study we evaluated ocular biometric changes such as axial length, anterior chamber depth, lens thickness, horizontal corneal diameter and central corneal thickness in children with congenital glaucoma, to identify the value of these data in diagnosis and follow up. In present study a group of 38 eyes of 22 patients with congenital glaucoma from the attendants to glaucoma unit were recruited and scheduled for surgery. Of these, 17 eyes underwent CTTO surgery and 21 eyes underwent TO surgery. A control group of 40 eyes of 20 healthy normal patients of matched age and with no history of glaucoma, were also included. All parameters were obtained under general anaesthesia day before the surgery and at one month, 3 months and 6 months postoperatively by a single examiner. Three measurements were recorded for each parameter and a mean value was calculated. We found that eyes with congenital glaucoma presented with greater mean value of IOP, HCD, CCT, AL & ACD in relation to the control group except for LT, there was no statistically significance difference between both groups. The mean IOP was significantly decreased from 30.9 ± 6.2 mmHg and 27.1 ± 5.6 mmHg to 15.4 ± 1.9 mmHg and 13.9 ± 1.6 mmHg in CTTO and TO subgroups respectively. This was achieved by one CTTO in 13 eyes (76.5%); one TO in 19 eyes (90.5%); 2 CTTO in 4 eyes (23.5%) and 2 TO in 2 eyes (9.5%). The mean CCT were significantly decreased from 713.2 ± 220 µm to 524.5 ± 43.7 µm and from 629.4 ± 152.4 µm to 513.9 ± 24.4 µm in CTTO and TO subgroups respectively at last follow up while the difference between pre- and postoperative mean HCD was insignificant in study group. The mean AL was significantly increased at last follow up from 22.1 ± 1.4 mm to 23.3 ± 1.9 mm and from 22.1 ± 1.5 mm to 22.6 ± 1.2 mm in CTTO and TO subgroups respectively. Also, the mean LT was significantly increased from 3.5 ± 0.2 mm to 3.8 ± 0.2 mm and from 3.7 ± 0.2 mm to 3.9 ± 0.2 mm in CTTO and TO subgroups respectively meanwhile there was a significant short-term reduction of the mean ACD in both subgroups, which gradually increased to the preoperative value. We also found a good correlation between preoperative and final HCD and AL which confirm that the higher HCD and AL are before surgery, the greater they will be at final follow-up regardless of IOP control. In failed subgroup, the mean HCD and AL were significantly increased at last follow up while they were quite stable in successful IOP control subgroup which confirm the value of ocular biometry as an indicator of success of glaucoma surgery in children. All in all IOP and ocular biometry are complementary valuable parameter in the diagnosis and follow-up of congenital glaucomas.