Post-traumatic glaucoma with irido-corneal angle injuries in Cameroon

AIM: To study the particularities of late post-traumatic glaucoma with irido-corneal angle injuries in black Cameroonians. MATERIAL AND METHODS: Retrospective analysis of 1343 files of glaucomatous patients was carried out from January 1991 to December 2001 at the Douala General Hospital in Cameroon in Central Africa. Fifty seven of them had post-traumatic glaucoma. Of these 28 were secondary to irido-corneal angle injuries. RESULTS: The prevalence of post-traumatic glaucoma related to irido-corneal angle injuries in our population was 2.1%. The mean patients age was 45.9 +/- 18.3 years (range, 17 to 67 years). The time from injury to diagnosis ranged from 1 year 4 months to 7 years (median: 3.7 years). The follow-up period ranged from 3 months to 5 years 6 months, with a mean of 1.7 +/- 1.9 years. The prevalence of monocular blindness was 61.9% and 81% at the first and last examination respectively. The mean intraocular pressure was 36.9 +/- 13.8 mmHg (range: 22 and 66 mmHg) at the first examination and 24.3 +/- 13 mmHg (range: 12 and 29 mmHg) at the last examination. The mean recorded cup/disc ratio was 0.8 +/- 0.2. It was equal to 1.0 in 61.9% of cases. Irido-corneal angle recession was the most common lesion (61.9%) followed by iridodialysis (38.1%) and cyclodialysis (14.3%). Normalization of the intraocular pressure was achieved with medical treatment in 23.8% and with trabelectomy in 12.3% of the cases. Neovascular glaucoma was found in 4.8% of the cases. CONCLUSION: The treatment of secondary post-traumatic open angle glaucoma is disappointing. The patients are young, the disease is advanced, and the compliance and follow-up are poor. The prevention of post-traumatic glaucoma is based on the control of ocular trauma and the periodic follow-up of patients with and history of non perforating injury of the eye.