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Abstract #98471 Published in IGR 22-4
Trabeculotomy versus Combined Trabeculotomy-Trabeculectomy for Management of Primary Congenital Glaucoma
Yazdani S; Pakravan M; Gerami E; Doozandeh A; Esfandiari H; Sharifipour FJournal of Glaucoma 2022; 31: 346-350
PRECIS: Trabeculotomy alone is as safe and effective as combined trabeculotomy-trabeculectomy in patients with primary congenital glaucoma and requires significantly fewer examinations under anesthesia in the postoperative period. PURPOSE: To compare the outcomes of trabeculotomy (T) and combined trabeculotomy-trabeculectomy (TT) as the initial surgical procedure for patients with primary congenital glaucoma (PCG). METHODS: In this retrospective study, medical records of patients who had undergone T or TT as the initial procedure for PCG were reviewed. The primary outcome measure was surgical success, defined as 5 ≤IOP ≤21▒mmHg, IOP reduction of at least 20% with no need for further glaucoma surgery. Secondary outcome measures were the number of glaucoma medications and complications. RESULTS: 134 eyes from 134 patients with a mean follow-up of 8±6.6 years were included consisting of 106 and 28 eyes, which had undergone T and TT, respectively. Success rates were comparable with both surgical procedures at 1, 2, 3, 4 and 5 years with no statistically significant difference. IOP was significantly decreased from 27.5±4.2▒mmHg preoperatively to 15.62±3.4▒mmHg at the 5-year follow-up visit in the T group and from 25.3±6.5 to 17.1±3.2▒mmHg in the TT group. (P=0.1) There was no significant difference between the two groups in the number of glaucoma medications (P=0.2). Patients in the T group required significantly fewer examinations under anesthesia (EUAs) than the TT group (7.3±4.4 vs. 10.1±3.9, P=0.04). CONCLUSION: Trabeculotomy alone seems as effective as combined trabeculotomy-trabeculectomy and may significantly reduce exposure to anesthesia in PCG patients.
Ocular Tissue Engineering Research Center, Research Institute for Ophthalmology and Vision Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran Department of Ophthalmology, Labbafinejad Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran Ophthalmic Epidemiology Research Center, Research Institute for Ophthalmology and Vision Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran Ophthalmic Research Center, Research Institute for Ophthalmology and Vision Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran Ophthalmology Department, Olmsted Medical Center, Rochester, Minnesota, USA.
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