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 38.38±11.77 months (range 12–48 months). Mean IOP was 33.16±7.28 mmHg (range 23–50 mmHg) preoperatively. At the final follow-up visit, the mean IOP was 21.41±7.34 mmHg (range 8–38 mmHg). Pre-and postoperative IOP differences were statistically significant at all examination periods (P<0.001). 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=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.
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References
Duke-Elder S ed. System of Ophthalmology, Vol. 3, Part 2, Congenital deformities. St. Louis: CV Mosby, 1969.
DeLuise VP, Anderson DR . Primary infantile glaucoma (Congenital Glaucoma). Survival Ophthalmol 1983; 28 (1): 1–19.
Anderson DR . Trabeculotomy compared to goniotomy for glaucoma in children. Ophthalmology 1983; 90: 805–806.
Akimoto M, Tanihara H, Negi A, Nagata M . Surgical results of trabeculotomy ab externo for developmental glaucoma. Arch Ophthalmol 1994; 112: 1540–1544.
Debnath SC, Teichmann KD, Salamah K . Trabeculectomy vs trabeculotomy in congenital glaucoma. Br J Ophthalmol 1989; 73: 608–611.
Hoskins Jr HD, Shaffer RN, Hetherington J . Goniotomy vs trabeculotomy. J Pediatr Ophthalmol Strabismus 1984; 21: 153–158.
Barkan O . Technique of goniotomy. Arch Ophthalmol 1938; 19: 217–223.
Russell-Eggitt IM, Rice NSC, Jay B, Wyse RKH . Relapse following goniotomy for congenital glaucoma due to trabecular dysgenesis. Eye 1992; 6: 197–200.
Mc Pherson Jr SD, McFarland D . External trabeculotomy for developmental glaucoma. Ophthalmology 1980; 87: 302–305.
Meyer G, Schwenn O, Pfeiffer N, Grehn F . Trabeculotomy in congenital glaucoma. Graefe's Arch Clin Exp Ophthalmol 2000; 238: 207–213.
Dietlein TS, Jacobi PC, Krieglstein GK . Prognosis of primary ab externo surgery for primary congenital glaucoma. Br J Ophthalmol 1999; 83: 317–322.
Song J, Stinnett SS, Whitson JT, Kooner KS . Ten-year surgical experience with childhood glaucoma. J Pediatr Ophthalmol Strabismus 2003; 40: 11–18.
Mandal AK, Prasad K, Naduvilath TJ . Surgical results and complications of Mitomycin-C augmented trabeculectomy in refractory developmental glaucoma. Ophthalmic Surg Lasers 1999; 30: 473–480.
Rodrigues AM, Paranhos Jr A, Montezano FT, Melo PAA, Prata Jr J . Comparision between results of trabeculectomy in primary congenital glaucoma with and without the use of Mitomycin C. J Glaucoma 2004; 13: 228–232.
Yalvac IS, Nurozler A, Kahraman C, Kasim R, Duman S . The results of trabeculectomy with and without Mitomycin-C in young patients. Ophthalmologica 1998; 212: 399.
Ikeda H, Ishigooka H, Muto T, Tanihara H, Nagata M . Long-term outcome of trabeculectomy for the treatment of developmental glaucoma. Arch Ophthalmol 2004; 122: 1122–1128.
Beck AD, Lynch MG . 360 degrees trabeculotomy for primary congenital glaucoma. Arch Ophthalmol 1995; 113: 1200–1202.
Mendicino ME, Lynch MG, Drack A, Beck AD, Harbin T, Pollard Z et al. Long-term surgical and visual outcomes in primary congenital glaucoma. 360 degrees trabeculotomy versus goniotomy. J AAPOS 2000; 4: 205–210.
Filous A, Brunova B . Results of the modified trabeculotomy in the treatment of primary congenital glaucoma. J AAPOS 2002; 6: 182–186.
Mandal AK, Bhatia PG, Bhaskar A, Nutheti R . Long-term surgical and visual outcomes in Indian children with developmental glaucoma operated on within 6 months of birth. Ophthalmology 2004; 111: 283–290.
Mandal AK, Gothwal VK, Bagga H, Nutheti R, Mansoori T . Outcome of surgery on infants younger than 1 month with congenital glaucoma. Ophthalmology 2003; 110: 1909–1915.
Mandal AK, Naduvilath TJ, Jayagandan A . Surgical results of combined trabeculotomy- trabeculectomy for developmental glaucoma. Ophthalmology 1998; 105: 974–982.
Biedner BZ, Rothkoff L . Combined trabeculotomy-trabeculectomy compared with primary trabeculotomy for congenital glaucoma. J Pediatr Ophthalmol Strabismus 1998; 35: 49–50.
Mullaney PB, Selleck C, Al-Awad A, Al-Mesfer S, Zwaan J . Combined trabeculotomy and trabeculectomy as an initial procedure in uncomplicated congenital glaucoma. Arch Ophthalmol 1999; 117: 457–460.
Quigley HA . Childhood glaucoma: results with trabeculotomy and study of reversible cupping. Ophthalmology 1982; 89: 219–226.
Akarsu AN, Turacli ME, Aktan SG, Barsoum-Homsy M, Chevrette L, Sayh BS et al. A second locus (GLC3B) for primary congenital glaucoma (buphthalmus) maps to the 1p36 region. Hum Mol Genet 1996; 5: 1199–1203.
Ho CL, Walton DS . Primary congenital glaucoma:2004 Update. J Pediatr Ophthalmol Strabismus 2004; 41: 271–288.
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The authors have no proprietary interest in any of the materials or techniques used in this study
Presented in part as a poster presentation at the Annual Meeting of the American Academy of Ophthalmology, New Orleans, Louisiana; October 2004
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Yalvac, I., Satana, B., Suveren, A. et al. Success of trabeculotomy in patients with congenital glaucoma operated on within 3 months of birth. Eye 21, 459–464 (2007). https://doi.org/10.1038/sj.eye.6702223
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DOI: https://doi.org/10.1038/sj.eye.6702223
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