Circumferential Trabeculotomy With an Illuminated Microcatheter in Congenital Glaucomas


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Abstract

Purpose:To determine the safety and efficacy of circumferential trabeculotomy for congenital glaucomas using an illuminated microcatheter.Methods:This was a retrospective chart study involving 11 eyes from 7 patients with primary or secondary congenital or juvenile glaucoma who underwent circumferential trabeculotomy performed with an illuminated microcatheter over a 2-year period. Data from eyes with 6 or more months of follow-up intraocular pressure (IOP) data were included in the analysis. Mean IOP was determined along with a survival analysis. Unqualified success was defined as an IOP<21 mm Hg and at least a 30% reduction in IOP without the use of IOP-lowering agents and a qualified success when medications were needed to reach this goal.Results:Mean IOP (mm Hg) was reduced from 33.8±6.3 preoperatively to 18.3±3.5 at the final postoperative visit (P-value<0.001). Length of follow-up was 8 to 12 months (mean of 11 mo). A qualified success was seen in 90.1% of eyes and an unqualified success in 81.8%. If eyes with previous angle surgery were excluded, the unqualified success was 87.5% and the qualified success was 100%. Transient hyphema was seen in all cases. No long-term surgical complications were seen.Conclusions:Circumferential trabeculotomy performed with an illuminated microcatheter provided significant IOP lowering in all patients with unqualified success in the majority of eyes and no significant complications. Further study with even longer follow-up is needed.

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