Microcatheter-assisted Trabeculotomy Versus 2-site Trabeculotomy With the Rigid Probe Trabeculotome in Primary Congenital Glaucoma

Sayed, Yasmine M. El; Gawdat, Ghada

doi:10.1097/ijg.0000000000000892

Cited by 25 publications

(26 citation statements)

References 14 publications

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“…The application of these microcatheters apart from canaloplasty surgery in POAG was also applied in pediatric patients with congenital glaucoma, where a microcatheter-assisted trabeculotomy yielded superior results in terms of IOP control and success rates in comparison with standard trabeculotomy. 11,12 The results of canaloplasty in general are well documented. 6,7,10 Given the fact that Glaucolight is no longer available, we assumed that iTrack 250A outperformed Glaucolight in terms of IOP control, success rates, and practicality.…”

Section: Discussionmentioning

confidence: 99%

Comparison of performance between two microcatheter systems in ab externo canaloplasty: A retrospective comparison study

Vastardis

Kontopoulou

Fili

et al. 2019

European Journal of Ophthalmology

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Purpose: To compare the performance of two different microcatheter systems, iTrack™ 250A and Glaucolight, in ab externo canaloplasty in three major categories: intraocular pressure reduction, drug therapy reintroduction, and evaluation of viscodilation over distension of the inner wall of Schlemm’s canal. Methods: A total of 56 and 46 eyes from different glaucoma types underwent ab externo canaloplasty using two different microcatheter systems. Group formation was made according to microcatheter system used. Kaplan–Meier test was performed for drug therapy reintroduction in relation to the two microcatheters. Tests of between-subject effects in two-way analysis of variance evaluated the efficacy of the two microcatheters and their features in relation to intraocular pressure reduction. Results: Kaplan–Meier test was not statistically significant (p = 0.20) regardless of microcatheter system. Tests of between-subject effects in relation to intraocular pressure reduction was not statistically different between the two microcatheters (p = 0.26) or between microcatheter and follow-up (p = 0.90). Intraocular pressure reduction in different glaucoma type was statistically significant during the follow-up period and glaucoma types showed different results between them in relation to follow-up (p < 0.001 and p = 0.002, respectively), but the pairwise comparison was not statistically important (p = 0.42). Intraocular pressure reduction was better in pseudophakic eyes in comparison with phakic eyes (p = 0.03), but the selection of microcatheter seemed not to affect this result (p = 0.11 and p = 0.32, respectively). Conclusion: Both microcatheter systems performed equal in terms of intraocular pressure reduction. Drug therapy reintroduction was not affected by the selection of the two microcatheters. Different types of glaucoma responded different to canaloplasty. Pseudophakic eyes responded better to treatment than phakic eyes, but the microcatheter selection seemed not affect this result.

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Section: Discussionmentioning

confidence: 99%

Comparison of performance between two microcatheter systems in ab externo canaloplasty: A retrospective comparison study

Vastardis

Kontopoulou

Fili

et al. 2019

European Journal of Ophthalmology

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“…El Sayed and Gawdat [21] also reported superiority of circumferential trabeculotomy in a randomized series of 62 patients. When opening Schlemm's canal twice with a rigid probe using two entry sites, the success rate equals that of circumferential microcatheter trabeculotomy [22]. Circumferential microcatheter trabeculotomy was shown to be equally effective as combined trabeculotomy-trabeculectomy [15].…”

Section: Results Of Circumferential Trabeculotomymentioning

confidence: 99%

Therapy of congenital glaucoma

Grehn

2020

Ophthatherapy

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The primary therapy of all forms of primary and secondary congenital glaucoma is surgical. In the last few decades, the options for customized surgical approach to different types of childhood glaucoma have significantly developed. In particular, circumferential trabeculotomy has shown some superiority over conventional trabeculotomy and is now also used to treat secondary congenital glaucoma. Goniotomy is still a valid alternative. Tube implants in childhood glaucoma still need improvements.

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“…In addition, the illuminated microcatheter requires a greater cost than the standard rigid probe trabeculotomy. In a prior study by El Sayed et al in primary congenital glaucoma, a two-site rigid-probe trabeculotomy is described in which scleral flaps are made through the superonasal and inferotemporal quadrants to gain 360 • access with a rigid probe instead of a microcatheter [62]. In addition to being less costly and avoiding additional manipulation of prime ocular real estate necessary for tube and filtering procedures, outcomes were similar between the two results.…”

Section: Two-site Rigid Probe Trabeculotomymentioning

confidence: 90%

Angle Surgery in Pediatric Glaucoma Following Cataract Surgery

Jamerson

Solyman

Yacoub

et al. 2021

Vision

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Glaucoma is a common and sight-threatening complication of pediatric cataract surgery Reported incidence varies due to variability in study designs and length of follow-up. Consistent and replicable risk factors for developing glaucoma following cataract surgery (GFCS) are early age at the time of surgery, microcornea, and additional surgical interventions. The exact mechanism for GFCS has yet to be completely elucidated. While medical therapy is the first line for treatment of GFCS, many eyes require surgical intervention, with various surgical modalities each posing a unique host of risks and benefits. Angle surgical techniques include goniotomy and trabeculotomy, with trabeculotomy demonstrating increased success over goniotomy as an initial procedure in pediatric eyes with GFCS given the success demonstrated throughout the literature in reducing IOP and number of IOP-lowering medications required post-operatively. The advent of microcatheter facilitated circumferential trabeculotomies lead to increased success compared to traditional <180° rigid probe trabeculotomy in GFCS. The advent of two-site rigid-probe trabeculotomy indicated that similar results could be attained without the use of the more expensive microcatheter system. Further studies of larger scale, with increased follow-up, and utilizing randomization would be beneficial in determining optimum surgical management of pediatric GFCS.

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Microcatheter-assisted Trabeculotomy Versus 2-site Trabeculotomy With the Rigid Probe Trabeculotome in Primary Congenital Glaucoma

Abstract: Circumferential trabeculotomy using either the illuminated microcatheter or rigid probe trabeculotome yielded comparable results; however, the added cost of the microcatheter should be considered.

Cited by 25 publications

References 14 publications

Comparison of performance between two microcatheter systems in ab externo canaloplasty: A retrospective comparison study

Comparison of performance between two microcatheter systems in ab externo canaloplasty: A retrospective comparison study

Therapy of congenital glaucoma

Angle Surgery in Pediatric Glaucoma Following Cataract Surgery

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