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360° trabeculotomy reduces IOP in select pediatric patients
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 Jennifer B. Dao |
SAN ANTONIO — Trabeculotomy can reduce IOP in select cases of aphakic glaucoma and juvenile open-angle glaucoma, a speaker said here.
"Angle surgery is traditionally used as the first-line therapy for primary congenital infantile glaucoma," Jennifer B. Dao, MD, said at the American Association for Pediatric Ophthalmology and Strabismus meeting.
"When it comes to aphakic glaucoma and juvenile open-angle glaucoma, they are often resistant to medical therapy," she said, adding that they are often treated with more invasive therapy, such as drainage implant, trabeculectomy or cycloablation.
Dr. Dao and colleagues evaluated their success in performing 360° trabeculotomy using the iTrack illuminated microcatheter (iScience) in 13 cases of aphakic glaucoma and seven cases of juvenile open-angle glaucoma. Success was considered to be IOP less than or equal to 22 mm Hg, which had to represent at least a 25% reduction in IOP. IOP had to be clinically adequate for the glaucoma status with or without topical IOP-lowering drugs.
Patients were selected only if trabeculotomy was the standard first surgery, and they were excluded if they had prior glaucoma surgery or angles with extensive synechiae.
Complete 360° cannulation with the iTrack catheter was done in eight of the 13 aphakic glaucoma subjects, achieving a 62% rate of success according to the success criteria, and in seven of eight of the juvenile open-angle glaucoma subjects, achieving a success rate of 88%.
Most common complications included transient hyphema and vitreous hemorrhage in the aphakic patients.
When the surgery failed, it did so quickly, Dr. Dao said, and did not preclude other glaucoma procedures from being done.
- Disclosure: Dr. Dao has no relevant financial disclosures.