Long-term Surgical Outcome of Eleven Patients with Glaucoma Secondary to the Iridocorneal Endothelial Syndrome

Purpose: To report the long-term outcome of patients with iridocorneal endothelial syndrome (ICE) who required surgery for glaucoma. Materials Methods: This retrospective, noncomparative case series was conducted on 11 patients with ICE who underwent surgery to control their glaucoma between 1992 and 2004 in Farabi Eye Hospital. The first surgery was trabeculectomy with Mitomycin C except in one patient in whom Mitomycin C was not used. If intraocular pressure was not controlled, redo trabeculectomy and alternative procedures such as Molteno tube implantation, bleb revision, andcyclodestructive procedures were performed.Results: Nine patients were female and two were males. The mean age of the patients was 39.4±11.2 years and they were followed for a median of 22 months (minimum: 6, maximum: 146 months). The first surgery in all patients was trabeculectomy with adjunctive Mitomycin C except in one for whom trabeculectomy was carried out without Mitomycin C. Seven (63.7%) patients had intraocular pressure less than 21 mm Hg; only one of them was on topical medications. Four (36.4%) of the patients had intraocular pressure less than 21 mm Hg after the first surgery at the last follow up. The IOP was controlled in one patient after the second trabeculectomy and in two other cases it was controlled following other procedures such as bleb revision and cyclodestructive procedures (following the second trabeculectomy). The surgical intervention failed in four patients; two of them had intraocular pressure 21 mm Hg after the first surgery and the other two developed no light perception vision despiet Molteno tube implantation. Seven (63.7%) of the patients had visual acuity of ≥20/200 at the last visit. In one patient due to corneal decompensation penetrating keratoplasty was done. Conclusion: Glaucoma associated with ICE syndrome can be managed successfully surgically in the majority of cases, however multiple procedures are often needed.