Skip to main content
PMC home page
The British Journal of Ophthalmology logoLink to The British Journal of Ophthalmology
. 1991 Oct;75(10):584–590. doi: 10.1136/bjo.75.10.584

Trabeculectomy combined with beta irradiation for congenital glaucoma.

M H Miller 1, N S Rice 1
PMCID: PMC1042493  PMID: 1954206

Abstract

Sixty-six eyes with congenital glaucoma were subjected to trabeculectomy between July 1975 and June 1989 are presented. Thirty-one were treated with beta irradiation at the time of surgery with a strontium-90 applicator; 35 were not treated with beta irradiation. The usual dose was 750 rad. Analysis was limited to three years because of the shorter follow-up of the irradiated eyes. Failure in the two groups was compared statistically. When failure was categorised as IOP greater than 21 mm Hg, beta irradiation was found to be significantly protective with an adjusted risk ratio of 0.31 (95% confidence interval 0.11-0.90, p less than 0.05). Failure categorised as the need for additional medical treatment or further surgery showed significant protection with an adjusted risk ratio of 0.33 (confidence interval 0.12-0.94, p less than 0.05). Multiple regression models were used for the analysis of intraocular pressure; beta irradiation was associated with a significantly lower IOP at six months, one year, and three years (p less than 0.05). Other factors identified as being associated with a reduced failure rate or lower IOP were: no previous topical glaucoma medications: age over seven years; lack of previous surgery involving the conjunctiva. The results indicate that beta irradiation may have a beneficial effect on the prognosis of trabeculectomy in children with congenital glaucoma. However, because of the retrospective and observational nature of the study, the results must be regarded as tentative.

Full text

PDF
589

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. ANTON M., RIEBEL O. [Effect of beta rays on healing of sclero-corneal lesions]. Scr Med (Brno) 1961;34:293–296. [PubMed] [Google Scholar]
  2. Bahrassa F., Datta R. Postoperative beta radiation treatment of pterygium. Int J Radiat Oncol Biol Phys. 1983 May;9(5):679–684. doi: 10.1016/0360-3016(83)90234-1. [DOI] [PubMed] [Google Scholar]
  3. Barron A., McDonald J. E., Hughes W. F. Long-term complications of beta-radiation therapy in ophthalmology. Trans Am Ophthalmol Soc. 1970;68:113–128. [PMC free article] [PubMed] [Google Scholar]
  4. Beauchamp G. R., Parks M. M. Filtering surgery in children: barriers to success. Ophthalmology. 1979 Jan;86(1):170–180. doi: 10.1016/s0161-6420(79)35547-6. [DOI] [PubMed] [Google Scholar]
  5. COHEN L. B., GRAHAM T. F., FRY W. E. Beta radiation; as an adjunct to glaucoma surgery in the Negro. Am J Ophthalmol. 1959 Jan;47(1 Pt 1):54–61. [PubMed] [Google Scholar]
  6. Cameron M. E. Beta irradiation as an adjunct to surgery in refractory glaucoma. Trans Aust Coll Ophthalmol. 1970;2:53–60. [PubMed] [Google Scholar]
  7. Cameron M. E. Thrombotic glaucoma successfully treated. Trans Ophthalmol Soc U K. 1973;93(0):537–547. [PubMed] [Google Scholar]
  8. FRIEDENWALD J. S. Some problems in the diagnosis and treatment of glaucoma. Am J Ophthalmol. 1950 Oct;33(10):1523–1538. doi: 10.1016/0002-9394(50)91212-8. [DOI] [PubMed] [Google Scholar]
  9. GRILLO H. C. Origin of fibroblasts in wound healing. An autoradiographic study of inhibition of cellular proliferation by local x-irradiation. Ann Surg. 1963 Mar;157:453–467. doi: 10.1097/00000658-196303000-00018. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. GRILLO H. C., POTSAID M. S. Studies in wound healing. IV. Retardation of contraction by localx-irradiation, and observations relating to the origin of fibroblasts in repair. Ann Surg. 1961 Nov;154:741–750. [PMC free article] [PubMed] [Google Scholar]
  11. Gressel M. G., Heuer D. K., Parrish R. K., 2nd Trabeculectomy in young patients. Ophthalmology. 1984 Oct;91(10):1242–1246. doi: 10.1016/s0161-6420(84)34179-3. [DOI] [PubMed] [Google Scholar]
  12. HUGHES W. F., Jr Beta radiation therapy in ophthalmology. Trans Am Ophthalmol Soc. 1952;50:469–549. [PMC free article] [PubMed] [Google Scholar]
  13. Heuer D. K., Parrish R. K., 2nd, Gressel M. G., Hodapp E., Desjardins D. C., Skuta G. L., Palmberg P. F., Nevárez J. A., Rockwood E. J. 5-Fluorouracil and glaucoma filtering surgery. III. Intermediate follow-up of a pilot study. Ophthalmology. 1986 Dec;93(12):1537–1546. doi: 10.1016/s0161-6420(86)33542-5. [DOI] [PubMed] [Google Scholar]
  14. ILIFF C. E., HAAS J. S. Posterior lip sclerectomy. Am J Ophthalmol. 1962 Oct;54:688–693. [PubMed] [Google Scholar]
  15. Inaba Z. Long-term results of trabeculectomy in the Japanese: an analysis by life-table method. Jpn J Ophthalmol. 1982;26(4):361–373. [PubMed] [Google Scholar]
  16. Jay J. L., Murray S. B. Early trabeculectomy versus conventional management in primary open angle glaucoma. Br J Ophthalmol. 1988 Dec;72(12):881–889. doi: 10.1136/bjo.72.12.881. [DOI] [PMC free article] [PubMed] [Google Scholar]
  17. Knapp A., Heuer D. K., Stern G. A., Driebe W. T., Jr Serious corneal complications of glaucoma filtering surgery with postoperative 5-fluorouracil. Am J Ophthalmol. 1987 Feb 15;103(2):183–187. doi: 10.1016/s0002-9394(14)74224-2. [DOI] [PubMed] [Google Scholar]
  18. Lavin M. J., Wormald R. P., Migdal C. S., Hitchings R. A. The influence of prior therapy on the success of trabeculectomy. Arch Ophthalmol. 1990 Nov;108(11):1543–1548. doi: 10.1001/archopht.1990.01070130045027. [DOI] [PubMed] [Google Scholar]
  19. MCDONALD J. E., WILDER H. C. The effect of beta radiation on corneal healing. Am J Ophthalmol. 1955 Nov;40(5 Pt 2):170–180. doi: 10.1016/0002-9394(55)91852-3. [DOI] [PubMed] [Google Scholar]
  20. McDONALD J. E., HUGHES W. F., Jr, PEIFFER V. G. Beta radiation cataracts. AMA Arch Ophthalmol. 1955 Feb;53(2):248–259. doi: 10.1001/archopht.1955.00930010250012. [DOI] [PubMed] [Google Scholar]
  21. Miller M. H., Grierson I., Unger W. G., Hitchings R. A. The effect of topical dexamethasone and preoperative beta irradiation on a model of glaucoma fistulizing surgery in the rabbit. Ophthalmic Surg. 1990 Jan;21(1):44–54. [PubMed] [Google Scholar]
  22. Miller M. H., Joseph N. H., Wishart P. K., Hitchings R. A. Lack of beneficial effect of intensive topical steroids and beta irradiation of eyes undergoing repeat trabeculectomy. Ophthalmic Surg. 1987 Jul;18(7):508–512. [PubMed] [Google Scholar]
  23. Ogino N., Masuda H., Abe Y. [Beta-irradiation in the filtering operation]. Nippon Ganka Gakkai Zasshi. 1966 Nov;70(11):1834–1839. [PubMed] [Google Scholar]
  24. Seigel D. G. Cox regression analysis in clinical research. Arch Ophthalmol. 1990 Jun;108(6):888–889. doi: 10.1001/archopht.1990.01070080132051. [DOI] [PubMed] [Google Scholar]
  25. Seigel D. Regression. Arch Ophthalmol. 1987 Feb;105(2):185–186. doi: 10.1001/archopht.1987.01060020039023. [DOI] [PubMed] [Google Scholar]
  26. Shaffer R. N., Hoskins H. D. Montgomery lecture. Goniotomy in the treatment of isolated trabeculodysgenesis (primary congenital [infantile] developmental glaucoma). Trans Ophthalmol Soc U K. 1983;103(Pt 6):581–585. [PubMed] [Google Scholar]
  27. Shuster J. N., Krupin T., Kolker A. E., Becker B. Limbus- v fornix-based conjunctival flap in trabeculectomy. A long-term randomized study. Arch Ophthalmol. 1984 Mar;102(3):361–362. doi: 10.1001/archopht.1984.01040030279018. [DOI] [PubMed] [Google Scholar]
  28. Starita R. J., Fellman R. L., Spaeth G. L., Poryzees E. M., Greenidge K. C., Traverso C. E. Short- and long-term effects of postoperative corticosteroids on trabeculectomy. Ophthalmology. 1985 Jul;92(7):938–946. doi: 10.1016/s0161-6420(85)33931-3. [DOI] [PubMed] [Google Scholar]

Articles from The British Journal of Ophthalmology are provided here courtesy of BMJ Publishing Group

RESOURCES