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  • We reviewed the medical records of all 31 children (38 eyes) with acute corneal hydrops due to infantile glaucoma who underwent glaucoma surgery by 1 surgeon (AKM) at the LVPEI, Hyderabad, South India from January 1990 to December 2012. A detailed ocular examination was performed under anesthesia to establish the diagnosis of infantile glaucoma with acute corneal hydrops. The parameters documented during this examination included: corneal findings (horizontal corneal diameter using calipers, clarity, presence or absence of Haab’s striae and its location) and intraocular pressure (IOP) using Perkin’s hand-held tonometer, In addition, a detailed examination of the lacrimal sac and nasolacrimal duct was performed to rule out the possibility of sac infection. Upon completion of the examination under anesthesia (EUA), the findings were interpreted to establish the diagnosis and decision was taken for surgical intervention. Procedures such as refraction, gonioscopy and fundus evaluation were not possible preoperatively given the presence of corneal edema in all cases. The following information was collected for each patient: age at presentation (in months), gender, age at surgery, pre-and postoperative (at last follow-up visit) corneal diameter and clarity, and diameter, pre-and postoperative IOP, visual acuity, refractive error, number of antiglaucoma medications at last visit, bleb characteristics, complications, if any. The primary outcome was surgical success as observed at the last follow-up visit. Complete success was clearance of corneal edema and IOP of ≤ 16 mmHg in patients examined under general anaesthesia or < 21 mmHg in patients who were old enough to be examined with the slit—lamp. However, refractive error, gonioanomaly, disc evaluation were not considered in the definition of success given that corneal oedema prevented their assessment in the preoperative period. Consequently, comparison of these parameters was not possible between preoperative and postoperative visits Likewise, visual acuity was not considered in the definition of surgical success. Qualified success was defined when such IOP was maintained with one antiglaucoma medication (AGM). Failure was defined when such IOP could not be achieved even with the addition of one AGM; persistent corneal edema; reduction of vision to no light perception, devastating complications; additional glaucoma procedures (including cyclodestructive procedures). Devastating complications included endophthalmitis, retinal detachment or chronic hypotony. Primary CTT was the surgical technique performed in all cases. The methods undertaken for primary CTT have been described previously. [12, 13, 19–21] Briefly, the Schlemm’s canal was dissected under a partial thickness limbal-based triangular sclera flap and trabeculotomy ab externo was performed on the sides of the radial incision trabeculectomy was then performed in the usual manner. In cases of bilateral affliction, after completion of surgery on the first eye, the second eye was operated using a similar technique but with new a set instruments, drapes, gown, gloves etc., simulating a surgical procedure on a different patient.
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