Results of the susanna implant in patients with refractory primary congenital glaucoma

Abstract

Purpose: To evaluate the results of the Susanna implant in children with primary congenital glaucoma. Patients and methods: the authors report a retrospective noncomparative interventional case series of data from 24 eyes from 24 pediatric patients who underwent Susanna implant surgery for primary congenital glaucoma. All the patients were operated by the same surgeon. the postoperative follow-up time was 24 months for all patients. Success was defined by an IOP higher than 6 mm Hg and less than or equal to 15 mm Hg, with the concomitant use of a single medication if necessary. Results: the age range of the patients was 1 to 15 years and the mean age was 5.04 +/- 4.12 years. At 12 months, 87.5% of the patients were considered as success, and at 24 months, the proportion dropped to 79.16%. Mean preoperative and postoperative intraocular pressure were 26.17 +/- 5.16 and 14.04 +/- 4.19 mm Hg (p < 0.001), respectively. All 24 children had undergone previous glaucoma surgeries. Cataract was the only complication found during follow-up, occurring in three patients. Cox's regression model did not show influence of gender (P = 0.740) and previous surgery (P = 0.262) on the outcome through time. Age at the time of surgery was the only variable which was statistically associated with success through time, younger patients presenting higher probability of failure (P = 0.05). Conclusions: the results of the present study reinforce the role of drainage implants as a safe alternative in difficult cases of primary congenital glaucoma, after failure of the initial approach.