Le glaucome du sujet jeune

Achieving an adequate intraocular pressure (IOP) is critical to the successful management of children affected with juvenile glaucoma, in whom medical therapy is often insufficient to control IOP. Anti-glaucoma eyedrops are usually not approved for use in children but, however, are frequently used in pediatrics. Although ocular hypotensive eyedrops may be well tolerated in young patients, their chronic use is often problematic because of systemic side effects or noncompliance. Glaucoma filtering surgery with adjunctive antifibrosis therapy (particularly with mitomycin C), aqueous shunt surgery and cyclodestructive procedures are currently undertaken in patients with juvenile glaucoma. Filtration surgery is usually less successful in patients with juvenile glaucoma: the higher failure rate stems from the excessive wound healing response in younger patients, resulting in subconjunctival fibrosis.