Illuminated Microcatheter Circumferential Trabeculotomy Versus Combined Trabeculotomy-Trabeculectomy for Primary Congenital Glaucoma: A Randomized Controlled Trial

Temkar, Shreyas; Gupta, Shikha; Sihota, Ramanjit; Sharma, Reetika; Angmo, Dewang; Pujari, Amar; Dada, Tanuj

doi:10.1016/j.ajo.2014.12.001

Cited by 46 publications

(33 citation statements)

References 31 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…[14] and Dada et al . performed the first prospective, randomized trial of thirty patients (sixty eyes) with bilateral PCG aged ≤2 years, with one eye of each patient being randomized to: illuminated microcatheter – assisted trabeculotomy (Group I) or combined trabeculotomy with trabeculectomy augmented with MMC (Group II).…”

Section: Circumferential Trabeculotomy For Primary Congenital Glaucomamentioning

confidence: 99%

Innovations in glaucoma surgery from Dr. Rajendra Prasad Centre for Ophthalmic Sciences

Dada

Midha

Shah

et al. 2017

Indian J Ophthalmol

Self Cite

View full text Add to dashboard Cite

Trabeculectomy surgery is the current standard of care in glaucoma for achieving a low target intraocular pressure if medical therapy is not adequate. Augmentation of trabeculectomy with antimetabolites brought a revolutionary change in the long-term success rates of trabeculectomy, but along with it came a plethora of complications. There still is a big window for therapeutic innovations on this subject. The foremost target for these innovations is to modulate the wound healing response after glaucoma drainage surgery. Achieving the desired balance between long-term success of filtering blebs versus early failure due to scarring of blebs and hypotony due to dysfunctional filtering blebs poses a unique challenge to the ophthalmologists. Alternatives to trabeculectomy such as glaucoma drainage devices and minimally invasive glaucoma surgeries cannot solve the problem of glaucoma blindness in our country, mainly due to their unpredictable results and unfavorable cost-benefit ratio. In this article, we present a summary of our innovations in glaucoma surgery to advance patient care by making it more effective, safer, and economical.

show abstract

Section: Circumferential Trabeculotomy For Primary Congenital Glaucomamentioning

confidence: 99%

Innovations in glaucoma surgery from Dr. Rajendra Prasad Centre for Ophthalmic Sciences

Dada

Midha

Shah

et al. 2017

Indian J Ophthalmol

Self Cite

View full text Add to dashboard Cite

show abstract

“…[ 34 – 37 ] Recently, 360° trabeculotomy has emerged as an attractive choice which can be performed with 6’O Proline suture or with the help of an illuminated microcatheter. [ 17 , 38 – 41 ] Several encouraging reports have emerged in the literature favoring circumferential trabeculotomy with illuminated microcatheter. [ 17 , 39 – 41 ] Steep learning curve and the cost of therapy using disposable illuminated microcatheter is a limiting factor especially in our scenario of a developing country.…”

Section: Discussionmentioning

confidence: 99%

Acute Corneal Hydrops in Children with Primary Infantile Glaucoma: A Report of 31 Cases over 23 Years at the LVPEI

Mandal¹

2016

PLoS ONE

View full text Add to dashboard Cite

PurposeRelatively little data exist regarding the outcomes of children with primary infantile glaucoma presenting with acute corneal hydrops. The aim of our study was to determine the surgical outcome of children of infantile glaucoma who presented with acute corneal hydrops.MethodsIn total, 38 eyes of 31 consecutive children of infantile glaucoma presented with acute corneal hydrops who underwent primary combined trabeculotomy-trabeculectomy (CTT) by a single surgeon from January 1990 to December 2012 at the LV Prasad Eye Institute (LVPEI), a tertiary eye care centre in Southern India were enrolled in this retrospective study. Primary outcome measures were intraocular pressure (IOP) control (IOP ≤ 16 mmHg under anaesthesia or IOP ≤ 21 mmHg without anaesthesia) and clearance of corneal edema. Secondary outcome measures were visual acuity (VA), corneal diameter, bleb appearance, intraoperative and postoperative complications.ResultsMean age at presentation was 6.4 months (range, 2–11 months) and seven eyes (23%) had bilateral affliction. At presentation, all eyes (100%) had moderate to severe degree of corneal edema with a mean preoperative IOP of 25.6 ±5.1 mmHg. Postoperatively, the IOP reduced to 12.0 ± 3.8 mmHg (difference = -13.6, 95% CI = -15.7 to -11.5, t = -13.18, p<0.0001), and the percentage reduction in IOP was 53.05%. Preoperatively 83% of the eyes were on antiglaucoma medication, and postoperatively 2 eyes (5.3%) required 1 antiglaucoma medication for control of IOP. Preoperatively, corneal edema was present in all eyes and postoperatively it cleared in all of them. Significant myopic astigmatism was present in 28 eyes (74%), the commonest being compound myopic astigmatism (75%) followed by simple myopic astigmatism (21%). Normal VA (best-corrected VA; BCVA ≥ 20/60) was achieved in 44.4% of the eyes and 22.2% eyes had low vision (BCVA, <20/60 to 20/400). Complete success (IOP control and clearance of corneal oedema) was obtained in 94.7% eyes. There were no significant intraoperative or postoperative complications. Two thirds of the patients showed low, elevated functional filtering bleb. No patient had any bleb leak, blebitis or bleb related endophthalmitis. The median follow-up was 36 months (range 2–228 months).ConclusionsPrimary CTT is safe and effective in controlling IOP, resulting in complete clearance of corneal edema with modest visual improvement in children of infantile glaucoma presenting with acute corneal hydrops. The outcome of the study will have a positive impact on counseling the parents preoperatively.

show abstract

“…67 gegenüber 47 % nach 2 Jahren in einer anderen Studie [16]) bzw. vergleichbare Resultate zur stärker invasiven kombinierten Trabekulotomie/Trabekulektomie mit Mitomycin C (MMC; 87 gegenüber 90 % nach 1 Jahr) [17]. Hierbei ist es nicht immer ein niedrigerer Intraokulardruck, sondern eher die höhere Erfolgsrate nach nur einem Eingriff, die herausragtwährend bei den konventionellen Verfahren häufigere Reoperationen nötig waren.…”

Section: Die 360°-trabekulotomieunclassified

Glaukomchirurgie bei Vorderabschnittsdysgenesien

Oterendorp

2019

Klin Monatsbl Augenheilkd

View full text Add to dashboard Cite

ZusammenfassungKongenitale Vorderabschnittsdysgenesien sind selten und treten meist sporadisch auf. Ihre phänotypische Ausprägung ist sehr variabel. In etwa 50% aller Fälle tritt ein Glaukom auf – entweder als Teil der Dysgenesie oder als Sekundärglaukom, vor allem nach Lentektomie bei kongenitaler Katarakt. In diesem Übersichtsartikel werden neben den embryologischen Grundlagen und dem Spektrum der Erkrankungen vor allem die chirurgischen Möglichkeiten zu Senkung des intraokularen Drucks vorgestellt. Ein Schwerpunkt liegt hierbei auf der in letzter Zeit zunehmend angewandten mikrokatheterassistierten 360°-Trabekulotomie sowie dem Einsatz von Drainageimplantaten.

show abstract

Illuminated Microcatheter Circumferential Trabeculotomy Versus Combined Trabeculotomy-Trabeculectomy for Primary Congenital Glaucoma: A Randomized Controlled Trial

Cited by 46 publications

References 31 publications

Innovations in glaucoma surgery from Dr. Rajendra Prasad Centre for Ophthalmic Sciences

Innovations in glaucoma surgery from Dr. Rajendra Prasad Centre for Ophthalmic Sciences

Acute Corneal Hydrops in Children with Primary Infantile Glaucoma: A Report of 31 Cases over 23 Years at the LVPEI

Glaukomchirurgie bei Vorderabschnittsdysgenesien

Contact Info

Product

Resources

About