Endoscopic goniotomy with anterior chamber maintainer: surgical technique and one-year results

The surgical technique of endoscopic goniotomy (EG) using the anterior chamber maintainer (ACM) for congenital glaucoma is evaluated, and one-year follow-up data are presented. Endoscopic goniotomy was performed in 12 eyes of 7 patients. A double-port-special goniotomy knife mounted on the endoscope's probe inserted through the first incision and ACM through the second incision-EG technique was used in 6 eyes of 3 patients, while a three-port-knife, endoscope probe, and ACM inserted through separate incisions-technique was preferred in the remaining 6 eyes of 4 patients. EG of approximately 240 degrees could be done without major complications in all eyes. At the end of the average follow-up period of 14.2 +/- 9.7 months, the mean intraocular pressure was reduced from 38.3 +/- 6.9 mm Hg to 17.6 +/-, 2.8 mm Hg (P = 0.002), the average number of glaucoma medications from 2.1 +/- 0.3 to 0.3 +/- 0.5 (P = 0.001), and the mean cup/disk ratios from 0.84 +/- 0.11 to 0.79 +/- 0.14 (P = 0.014), while there was no statistically significant change in the average corneal diameter (P = 0.16). Therefore, endoscopic goniotomy with ACM was found to be an effective treatment modality for congenital glaucoma.