Outcomes of Microcatheter-Assisted Trabeculotomy for Glaucoma Associated With Sturge-Weber Syndrome and Phakomatosis Pigmentovascularis

Man Hu; Tianwei Liang; Fei Leng; Bin Zhang; Yongli Xu; Hui Zeng; L I Li; Huaizhou Wang

doi:10.1016/j.ajo.2022.12.005

Outcomes of Microcatheter-Assisted Trabeculotomy for Glaucoma Associated With Sturge-Weber Syndrome and Phakomatosis Pigmentovascularis

Am J Ophthalmol. 2023 Apr:248:51-59. doi: 10.1016/j.ajo.2022.12.005. Epub 2022 Dec 10.

Authors

Man Hu¹, Tianwei Liang¹, Fei Leng¹, Bin Zhang², Yongli Xu³, Hui Zeng³, L I Li⁴, Huaizhou Wang⁵

Affiliations

¹ From Department of Ophthalmology, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China (M.H, T.L, F.L, L.L).
² Department of Dermatology, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China (B.Z).
³ Department of Mathematics, Beijing University of Chemical Technology, Beijing, China (Y.X, Z.H).
⁴ From Department of Ophthalmology, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China (M.H, T.L, F.L, L.L). Electronic address: liliyk2@163.com.
⁵ Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China (H.W). Electronic address: trhz_wang@163.com.

PMID: 36513156
DOI: 10.1016/j.ajo.2022.12.005

Abstract

Purpose: To evaluate mid-term efficacy and safety of ab externo Microcatheter-assisted trabeculotomy (MAT) for early-onset glaucoma associated with Sturge-Weber syndrome (SWS) and phakomatosis pigmentovascularis (PPV).

Design: Retrospective, non-comparative, interventional case series.

Methods: Medical records of consecutive SWS- or PPV-associated glaucoma patients who had undergone ab externo MAT between August 2017 and April 2020 at Beijing Children's Hospital were reviewed. Success was defined as an intraocular pressure (IOP) of <21 mmHg with (qualified success) or without (complete success) the use of antiglaucoma medication.

Results: Overall, 13 eyes (12 patients) with SWS and 9 eyes (8 patients) with PPV were included, with a mean age of 12.8 ± 15.8 months at the time of surgery and a mean follow-up time of 39.5 ±10.4 months. Both the SWS (26.5 ± 5.3 mmHg at baseline vs 16.5 ± 5.0 mmHg at the last visit; P < .001) and PPV (29.2 ± 7.5 mmHg vs 23.4 ± 4.7 mmHg; P = .014) subsets achieved a statistically significant fall in IOP following surgery. The Kaplan-Meier survival rate of complete (qualified) success after 42 months was 76.2% (87.5%) and 22.2% (40.0%) for eyes with SWS and PPV, respectively. Complications were minimal. Phakomatosis pigmentovascularis was associated with worse surgical outcomes.

Conclusions: Ab externo MAT is an effective and safe treatment for early-onset glaucoma associated with SWS, but a gradual increase in IOP over time was noted in some patients. Ab externo MAT has limited efficacy for early-onset glaucoma associated with PPV in the mid-term.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Child
Child, Preschool
Follow-Up Studies
Glaucoma* / complications
Glaucoma* / surgery
Humans
Infant
Intraocular Pressure
Neurocutaneous Syndromes* / complications
Neurocutaneous Syndromes* / surgery
Retrospective Studies
Sturge-Weber Syndrome* / complications
Sturge-Weber Syndrome* / diagnosis
Sturge-Weber Syndrome* / surgery
Trabeculectomy* / adverse effects
Treatment Outcome

Supplementary concepts

Early-Onset Glaucoma
Phacomatosis pigmentovascularis