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Abstract #8029 Published in IGR 4-3
Results of the modified trabeculotomy in the treatment of primary congenital glaucoma
Filous A; Brunova BJournal of AAPOS 2002; 6: 182-186
PURPOSE: To evaluate the effect of trabeculotomy using probes with curvatures more closely corresponding to the variable course of Schlemm's canal. METHODS: Forty-six children with primary congenital glaucoma who underwent trabeculotomy with newly designed probes between 1990 and 1998 were evaluated retrospectively. One set of the newly designed instruments consists of three pairs of trabeculotomy probes, the curvatures of which correspond to corneal diameters of 10, 12, and 14 mm. The criteria for surgical success were intraocular pressure (IOP) below 21 mmHg and simultaneous absence of cup-to-disc (C/D) ratio progression and of disproportional enlargement of the cornea. RESULTS: Forty-six children who underwent surgery over the course of seven years were evaluated in a follow-up period from seven to 83 months (38.4 ± 22.5 months). A total of 102 trabeculotomies were performed in a total of 78 eyes, with the following complications: eight large intraoperative hemorrhages, three small iris prolapses, two small descemetolyses, and one short iridodialysis. Postoperatively, glaucoma was successfully controlled in 68 eyes (87%), IOP fell in average from 30.81 ± 6.55 to 16.32 ± 5.13 mmHg (p < 0.00005). Visual acuity was better than 0.4 in 50 eyes and worse than 0.1 in five eyes at the end of the study. CONCLUSIONS: The probing of Schlemm's canal was feasible in all procedures and the number of complications was low. The success rate of surgery was high. The adaptation of trabeculotomy probes to Schlemm's canal curvature seems to make probing easier and safer.
A. Filous, MD, Charles University, 2nd Medical Faculty, Department of Ophthalmology, Prague, Czech Republic
Classification:
12.9 Trabeculotomy, goniotomy (Part of: 12 Surgical treatment)
