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Abstract #26706 Published in IGR 12-3
Trabeculotomy without scleral flap for the treatment of pediatric glaucoma
Stahl ED; Olitsky SEJournal of AAPOS 2010; 14: 7
The purpose of this report is to describe a modification of the conventional trabeculotomy procedure. This retrospective, case series review examines 14 cases of trabeculotomy surgery performed without a scleral flap. In these cases, the radial scleral incision was initiated into full-thickness sclera and dissected posteriorly until Schlemm's canal was located. The scleral incision was then secured with 10-0 vicryl suture. Methods: Our patient database was searched for trabeculotomy surgeries performed since September 2006. The operative reports were reviewed and surgical data was collected on those cases done without a scleral flap. Data on age, gender, etiology of elevated intraocular pressure, corneal diameter, pre-op intraocular pressure, location of trabeculotomy site, evidence of canal, ability to cannulate in both directions, and 1 day postoperative examination of wound and anterior chamber were recorded. Results: Of the 14 cases there was no incidence of postoperative wound leak or flat anterior chamber. In all cases, Schlemm's canal was located and cannulated with the trabeculotome in both directions. Etiology of glaucoma treated in this study included infantile glaucoma, juvenile glaucoma, and aphakic glaucoma. Conslusions: This case series shows that trabeculotomy can be successfully completed without the use of a scleral flap. Abandoning the need for the scleral flap in trabeculotomy surgery may be beneficial in cases of advanced glaucoma in which the sclera has become stretched and thinned. Primary cases have also been found to be satisfactorily completed without the creation of a scleral flap.
E.D. Stahl.
Classification:
12.9 Trabeculotomy, goniotomy (Part of: 12 Surgical treatment)
9.1.2 Juvenile glaucoma (Part of: 9 Clinical forms of glaucomas > 9.1 Developmental glaucomas)