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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±11.77 months (range 12-48 months). Mean IOP was 33.16 ± 7.28 mmHg (range 23-50 mmHg) preoperatively. At the final follow-up visit, the mean IOP was 21.41 ± 7.34 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.
Dr. I.S. Yalvac, Glaucoma Department, Ankara Education and Research Hospital, Ankara, Turkey. iyalvac@hotmail.com
12.9 Trabeculotomy, goniotomy (Part of: 12 Surgical treatment)
9.1.1 Congenital glaucoma, Buphthalmos (Part of: 9 Clinical forms of glaucomas > 9.1 Developmental glaucomas)