advertisement
Abstract #13403 Published in IGR 8-1
Combined trabeculotomy and trabeculectomy in advanced primary developmental glaucoma with corneal diameter of 14 mm or more
Mandal AK; Matalia JH; Nutheti R; Krishnaiah SEye 2006; 20: 135-143
PURPOSE: To report the safety and efficacy of combined trabeculotomy and trabeculectomy (CTT) in advanced primary developmental glaucoma with corneal diameter 14 mm or more. PATIENTS AND METHODS: A total of 74 (121 eyes) consecutive patients aged 3 days-100 months (median, 10 months) with advanced developmental glaucoma were included. Primary CTT was performed by a single surgeon at a tertiary eye care centre in India over a 13-year period. The main outcome measures were changes in and final levels of intraocular pressure (IOP), corneal clarity, visual acuity, and refractive status. RESULTS: Mean preoperative IOP was 29.4 ± 7.6 mmHg (range, 10-56 mmHg) and mean postoperative IOP was 15.5 ± 6.6 mmHg (range, 6-38 mmHg) (P < 0.0001) with percentage reduction of 44.5 ± 27.1. Kaplan-Meier survival analysis revealed 3-, 6-, 9-, 12-, 24-, 48-, and 72-month success rates of 86.5, 80.5, 78.1, 75.5, 71.1, and 60.5%, respectively. Majority (80.5%) of the patients were myopes with mean spherical equivalent of 5.8 ± 4.5D (range, 0.75-22.0D). Using various age-appropriate testing procedures, at the final follow-up visit, 14 patients (41.2%) had age-appropriate normal visual acuity and 20 patients (58.8%) had subnormal visual acuity. Best-spectacle-corrected visual acuity of ≥ 20/60 was achieved in seven patients (26.9%). There were no sight-threatening intraoperative and postoperative complications. CONCLUSION: CTT is safe and effective in patients with advanced primary developmental glaucoma. It offers good IOP control with a low complication rate, with about one-third of patients achieving a visual acuity of 20/60 or better.
Dr. A.K. Mandal, Jasti V Ramanamma Children's Eye Care Centre, L V Prasad Eye Institute, Hyderabad, India. mandal@lvpei.org
Classification:
9.1 Developmental glaucomas (Part of: 9 Clinical forms of glaucomas)
12.8.1 Without tube implant (Part of: 12 Surgical treatment > 12.8 Filtering surgery)
12.9 Trabeculotomy, goniotomy (Part of: 12 Surgical treatment)
