“We pediatric ophthalmologists have been performing micro-incisional glaucoma surgery of sorts for decades,” Benjamin Ticho, MD of Ticho Eye Associates recently observed. “But the techniques and devices were relatively crude, especially compared to what’s available now.”
Glaucoma , a condition where the eye pressure is high enough to damage the optic nerve, is relatively uncommon in children. When present, however, glaucoma in children is notoriously difficult to treat, traditionally requiring multiple difficult operations to achieve often less than spectacular results.
Fortunately, recent advances in how adult glaucoma is treated have filtered their way into our armamentarium for young patients. The popularity of adult microincisional glaucoma surgery (MIGS) has exploded in recent years, often in conjunction with simultaneous cataract removal, but now increasingly as standalone treatment.
One recent retrospective study from the University of Miami (https://pubmed.ncbi.nlm.nih.gov/31647927/) demonstrated surgical success (intraocular pressure control adequate to forego further surgery and absence of major complications) in 2/3 of 46 eyes, using the Trab360 procedure (SightSciences). The best results (83% success rate) were found in children with primary congenital glaucoma, the most common form in this age group.
“Pediatric glaucoma has always been particularly challenging to treat, and only a few practitioners gain the needed experience to manage these children successfully,” Dr. Ticho explained. “Having these new treatment options has the potential to reduce both the number of eye medications and surgeries required to achieve success.
Benjamin H. Ticho, MD
* All information subject to change. Images may contain models. Individual results are not guaranteed and may vary.