Success of trabeculotomy in patients with congenital glaucoma operated on within 3 months of birth

Abstract

Aims To determine the efficacy and safety of trabeculotomy in congenital glaucoma patients operated on within first 3 months of birth. Methods A total of 36 eyes of 24 patients with congenital glaucoma, who underwent primary trabeculotomy within first 3 months of birth were included. Preoperative and postoperative intraocular pressures (IOP), corneal clarity, diameter, axial length, success rates, and complications were evaluated in this study.Results The mean follow-up was 38.38711.77 months (range 12-48 months). Mean IOP was 33.1677.28 mmHg (range 23-50 mmHg) preoperatively. At the final follow-up visit, the mean IOP was 21.4177.34 mmHg (range 8-38 mmHg). Pre-and postoperative IOP differences were statistically significant at all examination periods (Po0.001). A12-, 24-, and 36-month success rates were 92, 82, and 74%, respectively. Survival analysis regarding to gender, preoperative corneal diameter and consaguinity were not statistically significant. Only preoperative axial length was a statistically significant parameter (P ¼ 0.024) for success. Postoperatively normal corneal clarity was achieved in 29 eyes (80.5%). The main complications were shallow anterior chamber in one (4.2%) eye and detachment of Descement's membrane in two (8.4%) eyes. Conclusions Primary trabeculotomy is a safe and effective procedure for congenital glaucoma patients when operated within 3 months of birth. It has a favourable IOP control and a low rate of complications in three year period.

Combined trabeculotomy and trabeculectomy: outcome for primary congenital glaucoma in a West African population

“…Some factors shown to be associated with successful surgery are smaller corneal diameter, [33][34][35] and shorter axial lengths (o24 mm). 31,36 We did not measure axial lengths in our study, therefore we are unable to relate this to our results.…”

Clinical outcomes after Ahmed valve implantation in refractory paediatric glaucoma

“…[3][4][5][6][7] Goniotomy and trabeculotomy were initially considered for congenital glaucoma, with comparable results. [8][9][10][11] Viscotrabeculotomy, using viscoelastic material during trabeculotomy, may increase success rates through prevention of both postoperative haemorrhage and adhesion of the incision lips. 12,13 Trabeculectomy also shows encouraging results, and may be supplemented by mitomycin C or combined with trabeculotomy.…”

Circumferential Trabeculotomy With an Illuminated Microcatheter in Congenital Glaucomas

“…Reported success with goniotomy or conventional trabeculotomy ab externo are similar ranging from 78% to 93.4%. [3][4][5][6][7][8] However, the conventional approach using rigid metal instruments can only open approximately one third of the drainage angle in a single surgery. In many cases, multiple procedures are needed with either conventional trabeculotomy or goniotomy.…”