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

• Published in: Eye (London) Vol. 21; no. 4; pp. 459 - 464
• Main Authors: YALVAC, I. S, SATANA, B, SUVEREN, A, EKSIOGLU, U, DUMAN, S
• Format: Journal Article
• Language: English
• Published: Basingstoke Nature Publishing Group 01-04-2007
• Subjects: Biological and medical sciences; Cornea - pathology; Female; Glaucoma; Glaucoma - congenital; Glaucoma - physiopathology; Glaucoma - surgery; Glaucoma and intraocular pressure; Humans; Infant; Infant, Newborn; Intraocular Pressure - physiology; Kaplan-Meier Estimate; Male; Medical sciences; Miscellaneous; Ophthalmology; Postoperative Complications; Retrospective Studies; Trabeculectomy - methods; Treatment Outcome; Glaucoma; Human; Protozoa; Congenital; developmental glaucoma; Trabeculotomy; congenital glaucoma; Birth; Eye disease; Glaucoma (eye); Ciliata; Ophthalmology; Child; childhood glaucoma
• ISSN: 0950-222X; 1476-5454
• DOI: 10.1038/sj.eye.6702223

To determine the efficacy and safety of trabeculotomy in congenital glaucoma patients operated on within first 3 months of birth.
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.
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.
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.