Treatment Treatment of Primary Congenital Open -Angle Glaucoma by Dr. David S. Walton Treatment should be initiated promptly after the diagnosis is established. Medical treatment will often decrease the intraocular pressure, but will rarely control it satisfactorily. Surgery is hence indicated to effect permanent reduction of the intraocular pressure.
Medical treatment consists of agents that decrease the rate of aqueous humor formation.
Goniosurgery, filtration surgery, and implant surgery are the three options for the management of congenital glaucoma. For many patients with congenital glaucoma this can be a very effective operation. Children with more severe defects of the filtration channels often do not respond to goniosurgery, and filtration procedures may be required to bypass the malfunctioning system, creating a new egress passage for the aqueous humor. The results of this type of surgery may be disappointing due to the failure of the new passage to remain patent. Repeat surgery in an unoperated area may be necessary to achieve an adequate lowering of the eye pressure.