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Abstract #108373 Published in IGR 23-4
Circumferential-Suture-Viscotrabeculotomy Versus Rigid Probe Viscotrabeculotomy in Neonatal-onset Primary Congenital Glaucoma
Elwehidy AS; Bayoumi NH; Elzeini RM; Abdelkader AJournal of Glaucoma 2023; 32: 807-814
PURPOSE: To compare the surgical outcomes of viscocircumferential-suture-trabeculotomy(VCST) to rigid probe double-entry viscotrabeculotomy(DEVT) and rigid probe single-entry viscotrabeculotomy (SEVT) in infants with neonatal onset primary congenital glaucoma(PCG). DESIGN: Retrospective chart review. PATIENTS AND METHODS: Retrospective chart review of 64 eyes of 64 infants with neonatal-onset PCG referred to Mansoura Ophthalmic Center in Mansoura, Egypt between February 2008 and November 2018. Study groups included VCST, DEVT and SEVT and follow up covered 4 postoperative years. Complete (qualified) success was defined as an IOP≤18 mmHg and with 35% IOP reduction from baseline without (with) IOP-lowering medications or further surgical interventions, and without any sign of progression in corneal diameter, axial length, or optic disc cupping and without visual devastating complications. RESULTS: The mean±standard deviation age at presentation and at surgery of the study children was 3.63±1.74 days and 55.23±1.60 days respectively. The mean±standard deviation IOP and C/D ratio of all study eyes at presentation and at final follow up were 34.91±0.82 mmHg and 0.70±0.09 and 17.04±0.74 mmHg and 0.63±0.08 respectively. Complete success was achieved in 54.5%, 43.5% and 31.6% in the VCST, DEVT and SEVT groups respectively. A self limited hyphema was the commonest complication in all groups. CONCLUSIONS: Angle procedures are safe and marginally effective for the surgical treatment of neonatal onset PCG, bringing IOP under control for at least 4 years of follow up. Circumferential trabeculotomy as a first-line treatment has more favorable outcomes than rigid probe SEVT. Rigid probe viscotrabeculotomy offers an alternative for non-completed circumferential procedure.
Ophthalmology. Faculty of Medicine. Mansoura University. Mansoura, Egypt.
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