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Abstract #46082 Published in IGR 13-2
Endoscopic goniotomy (EG): An alternative approach for goniotomy
Orge FHJournal of AAPOS 2011; 15: 26
Purpose: The main stay of treatment of congenital glaucoma is surgical. Goniotomy tends to be the preferred initial angle reconstructing surgery when the cornea is clear. For the patients with cloudy cornea and poor intraocular pressure control (IOP) despite trabeculotomy, so far no other angle surgery has been routinely performed. We present a case series of useful application of endoscope in goniotomy. Methods: This is a retrospective case analysis of 3 patients (4 eyes) with congenital glaucoma. 2 of the patients were with cloudy corneas at the time of presentation. The last patient had Axenfeld-Rieger syndrome with extensive irido-corneal adhesions blocking the angle view. Despite trabeculotomies and consecutive maximal medical management the IOP were not controlled and the angle was not visible via gonioscopy in all the cases. Results: Case 1 the IOP decreased from 29 mm Hg to 15 mm Hg in the left eye and from 25 mm Hg to 15 mm Hg in the right eye with EG (follow- up, 26 months). The second case received temporal and superior trabeculotomy. With consecutive EG, IOP decreased from mid 30's to mid-teens with medical treatment (follow up 15 months). In the last case angle was not visible and despite trabeculotomy and goniotomy procedures ended up needing tube shunt procedure. But the inferionasal angle could only be visualized with the help of an endoscope (follow up 7 months). Discussion: No complications were noted in any of the cases. Conclusions: Endoscopic goniotomy is an effective surgical option in congenital glaucoma with cloudy corneas.
F.H. Orge.
Classification:
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)
