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

doi:doi:10.1038/sj.eye.6702223

Eye (2007) 21, 459–464. doi:10.1038/sj.eye.6702223; published online 6 January 2006

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

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

I S Yalvac¹, B Satana¹, A Suveren¹, U Eksioglu¹ and S Duman¹

¹Glaucoma Department, Ankara Education and Research Hospital, Ankara, Turkey

Correspondence: IS Yalvac, Alacam Sokak 12/5, Cankaya, 06690 Ankara, Turkey. Tel: +90 312 428 15 16; Fax: +90 312 428 15 09; E-mail: iyalvac@hotmail.com

Received 16 September 2005; Accepted 28 October 2005; Published online 6 January 2006.

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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 plusminus 11.77 months (range 12–48 months). Mean IOP was 33.167.28 mmHg (range 23–50 mmHg) preoperatively. At the final follow-up visit, the mean IOP was 21.417.34 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.