Gonioscopic findings in trabeculectomies in young children.

To discover why trabeculectomy often fails in children, we studied a series of 27 procedures, focusing on intraocular and scleral factors that prevent humoral drainage. Gonioscopy was performed under anesthesia with Fluothan (ICI, UK), and trabeculectomy was considered successful when values were equal to or lower than 20 mm Hg. Only ten procedures proved successful, and all had large basal iridectomies plus visible anterior scleral openings at gonioscopy. Possible causes for the 17 failures are listed, together with indications for revision surgery.