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Microcatheter-assisted trabeculotomy may manage primary congenital glaucoma
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Illuminated microcatheter-assisted trabeculotomy may be considered as an initial surgical procedure in the treatment of primary congenital glaucoma, according to a study.
The prospective randomized trial analyzed 60 eyes of 30 patients who were 2 years old or younger and had bilateral primary congenital glaucoma. Patients underwent illuminated microcatheter-assisted trabeculotomy in one eye (group 1) and combined mitomycin C-augmented trabeculotomy-trabeculectomy in the other eye (group 2).
At 1 year postoperatively, IOP was reduced by 46.92% and 46.61% in group 1 and group 2, respectively (P < .001). IOP was reduced by 49.25% in 24 eyes that underwent complete catheterization.
Absolute success, defined as IOP of 15 mm Hg or less with no medications, was attained in 26 eyes in group 1 and 27 eyes in group 2 after 1 year. Qualified success, defined as IOP of 15 mm Hg or less with medications, was attained in 28 eyes in each group. Of the eyes that underwent complete catheterization, 23 eyes attained absolute success and all 24 eyes attained qualified success.
There was a statistically significant improvement in corneal clarity at 1 year. Grade 1 corneal clarity was found in 24 eyes in each group. In addition, cup-to-disc ratio significantly improved in each group.
More eyes in group 1 than group 2 had hyphema (P = .0001). – by Kristie L. Kahl
Disclosure: The authors report no relevant financial disclosures.
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