Congenital Glaucoma (Buphthalmia)

Abstract

The treatment of congenital glaucoma has been a topic of vivid discussion for nearly one century.It is generally accepted that the treatment is operative, but which operation is the best one is not finally settled.Iridectomy, iridencleisis, Elliot's operation, sclerotomy, cyclydialysis and cyclodiathermy have been the most common operations for congenital glaucoma for a very long period.The operative results, however, have been very conflicting and difficult to evaluate, not only because the buphthalmic eye often has undergone more than one operation, but also because the follow-up periods usually have been short, ranging from 2 to 6 years in average.Only a few references can be mentioned from the comprehensive literaturereferences are listed in these papers. Goniotomy was introduced in the treatment of congenital glaucoma by Barkan (1942) and goniopuncture by Scheie ( 1950). Both reported favorable results from their operations (Barkan 1948, 1953, Scheie 1961, results which were by far better than those reported in the above-mentioned operations.During the last 20 years, therefore, goniotomy, goniopuncture or a combination of goniotomy and goniopuncture have become more and more common in the treatment of congenital glaucoma.Favorable results have also been reported by Haas (1955) and Worst ( 1966), among many others.Unfortunately, however, a really adequate long-term follow-up of goniotomy, goniopuncture and combined goniotomy-goniopuncture has still not been presented.The genetic aspects in congenital glaucoma have been evaluated by Westerlund (1947) among others, and Jensen (1960) has presented the longterm prognosis, specially with reference to the occupational prognosis.We still lack sufficient information on the long-term prognosis of the opera-448