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Management of congenital glaucoma in Gaza eye hospital

Management of congenital glaucoma in Gaza eye hospital. Dr maher alrayes m.sc. ,palestinian board of ophthalmology. Congenital glaucoma is one of the causes of blindness in pediatric age group Congenital glaucoma is 3-4 times higher in incidence in the middle east than western world.

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Management of congenital glaucoma in Gaza eye hospital

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  1. Management of congenital glaucoma in Gaza eye hospital Dr maher alrayes m.sc. ,palestinian board of ophthalmology

  2. Congenital glaucoma is one of the causes of blindness in pediatric age group • Congenital glaucoma is 3-4 times higher in incidence in the middle east than western world. • Worldwide 1: 10000 sur. Of ophth.1983 • Saudi Arabia 1:2500 bjo 1985 • West bank and Gaza strip 1:8210 bjo 1993 • Southern provinces of Palestine 1:3142

  3. This study is a retrospective study of all cases of congenital glaucoma treated surgically in Gaza eye hospital in the period from 1997 – 2008. • 69 procedures in 69 eyes of 40 patients were reviewed.

  4. Data of all cases from their medical records including medical examination, clinical evaluation at first presentation and surgical procedures involved in the management were evaluated • Data included

  5. Table 1- characteristics of patients included in the study

  6. Table :2 Number and percentage of cases according to geographic distribution

  7. Figure 2 Number of cases according to the geographic distribution

  8. Table 3 age distribution

  9. table 4 important data from clinical examination

  10. Tabel : 5 intraocular pressure

  11. According to the results of this study our primary surgical procedure for treatment of congenital glaucoma was trabeculectomy with antimetabolites. • The aim of surgery is to control the high intraocular pressure so prevent damage of optic nerve and reduce corneal oedema.

  12. Tabel: 6 Surgical procedures

  13. Figure 3 Surgical procedures

  14. 58 cases had trabeculectomy with mmc , the results were • 45 cases have excellent control of intraocular pressure • 10 cases controlled with medical treatment • 4 cases required retrab. • 10 cases had trabeculectomy with 5 fu • 2 have excellent control • 4 cases controlled with medical treatment • 4 cases required retrab.

  15. Trabeculectomy +mmc produced excellent control in 76 % of cases . • 16% required medical treatment for control. • 6% required retrab.

  16. Guide lines for prevention of blindness from congenital glaucoma • 1- Eye examination at birth ( pediatrician , ophthalmologist). • 2- Screening of preschool children. • 3- Early management of discovered cases (surgical,medical). • 4- Early management of complications ( cataract, retinal detachment, corneal opacities). • 5-Genetic counselling ( consanguinity). • 6-training of local ophthalmologists to be expert in the field of pediatric ophthalmology .

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