Primary chronic angle-closure glaucoma in younger patients

AIM: To evaluate the dinical outcomes of management in younger patients with primary chronic angle-closure glaucoma (PCACG). METHODS: Thirty-eight patients (50 eyes) aged 40 or younger with confirmed diagnosis of PCACG in advanced or late stage who received surgical treatment in Zhongshan Ophthalmic Center from January 2000 to December 2005 were retrospectively investigated. All patients underwent trabeculectomy. The mean follow-up was 23.6 +/- 7.5 months. Full ophthalmic examinations were performed. The clinical outcomes including dinical presentations, surgical results and complications were evaluated. RESULTS: The mean age of patients was 33.5 +/- 6.1 years old. There was a female preponderance (60.5%). The mean axial length was 22.4 +/- 3.5mm with 18.0% short axis of eyeball and 14% nanophthalmos. There was 60.0% flat anterior chamber depth (<1.9mm). Ultrasonic Biomicroscopy identified that plateau iris was the most common underlying etiology (80.6%). There was a statistically significant difference in intraocular pressure (IOP) reduction postoperatively vs preoperatively (P<0.001). Four eyes failed to control IOP and received second filtration surgery. The main postoperative complications included shallow anterior chamber (20.0%) and malignant glaucoma (12.0%). CONCLUSION: The younger PCACG patients in advanced or late stage can be effectively managed by trabeculectomy. They have more frequency of postoperative sustained shallow anterior chamber and malignant glaucoma. Careful ophthalmic examinations, delicate surgical procedures and well-managed technique of complications were suggested on younger PCACG patients.