Is viscotrabeculotomy superior to conventional trabeculotomy in the management of Egyptian infants with congenital glaucoma?

Abstract

ABSTRACT.Purpose: The aim of this study was to assess the efficacy of viscotrabeculotomy in the management of congenital glaucoma as compared to conventional trabeculotomy, in Egyptian infants. Methods: This is a prospective interventional randomized comparative study in which patients with primary congenital glaucoma were randomly allocated to either group A or B; viscotrabeculotomy (VT); and trabeculotomy (T), respectively. Patients were followed up regarding intra-ocular pressure (IOP), cup/disc (C/D) ratio and horizontal corneal diameter (HCD) for 6 months. A probability value (p value) <0.05 was considered significant. Results: Twenty-one eyes in group A and 20 eyes in group B were enrolled in the study. The mean preoperative IOP was 23.5 and 24.3 mmHg in the VT and T groups, respectively. Postoperatively, IOP dropped at six months to 14.7 and 17 mmHg in the VT and T groups, respectively. That was significant in either group when compared to preoperative IOP, but not significant between both groups at the same point of comparison. Conclusions: Both techniques were equally effective in the reduction in IOP in the management of congenital glaucoma, but viscotrabeculotomy did not appear to add more benefit to the surgical outcome than classic trabeculotomy.

Primary trabeculotomy compared to combined trabeculectomy–trabeculotomy in congenital glaucoma: 3‐year study

“…In the study by ElSheikha et al. (), complete success was achieved in 61.9% (13 eyes) of the viscotrabeculotomy group compared to 60.0% of the trabeculotomy group (12 eyes). Qualified success was recorded for one eye (4.8%) in the viscotrabeculotomy group compared to none in trabeculotomy group.…”

“…In the study by ElSheikha et al. (), 25% in the trabeculotomy group and 14.3% in the viscotrabeculotomy group had clear cornea through the follow‐up period, 8.3% and 7.1% in each group, respectively, with hazy corneal opacity and the rest showing Haab's striae.…”

“…In a comparative study by ElSheikha et al. (), they assessed the efficacy of viscotrabeculotomy in the management of congenital glaucoma as compared to conventional trabeculotomy, in Egyptian infants. The mean preoperative IOP was 24.3 mmHg in trabeculotomy group with HCD 13.3 mm and 22.2 mm axial length while it was 23.5 mmHg in the viscotrabeculotomy group with HCD 13.5 mm and 22.8 mm axial length.…”

“…In the study by ElSheikha et al. (), the follow‐up was at 1 day, 1 week, weekly for 1 month and then monthly for 6 months. Postoperatively, IOP dropped at 6 months to 14.7 mmHg and 17 mmHg in the viscotrabeculotomy and trabeculotomy groups, respectively.…”

Intravitreal Ranibizumab With Panretinal Photocoagulation Followed by Trabeculectomy Versus Visco-Trabeculotomy in Management of Neovascular Glaucoma

“…The surgical techniques are already reported in previous studies. 9–12 In brief, in Trab-MMC, trabeculectomy was performed through a limbal-based conjunctival flap, followed by creation of a 3 × 4 rectangular half-thickness sclera flap. MMC was applied in a concentration of 0.03% for 3 minutes through soaked surgical sponge inserted underneath the conjunctival flap and spread of a large surface area posterior to the limbus and planned scleral flap site then thoroughly irrigated by 200 mL of sterile normal saline.…”