[Combined deep sclerectomy and trabeculotomy in congenital glaucoma with complications]

Lately there has been growing interest in deep sclerectomy as a therapeutic approach for the management of congenital glaucoma.In theory, its pressure-lowering effect is independent of external filtration, which minimizes the risk of failure due to conjunctival or episcleral scarring. In patients who have failed to benefit from previous filtering procedures and have refractory congenital glaucoma,deep sclerectomy could become an alternative.

A 3-year-old girl with refractory congenital glaucoma underwent deep sclerectomy in her left eye. Intraoperatively, percolation through the trabeculodescemetic window was weak, so that the procedure was supplemented by a trabeculotomy.

By now, throughout a follow-up period of 20 months, stabilisation of disc cupping and ocular axial length has been achieved without additional glaucoma surgery or medications.

In patients with congenital glaucoma,the combination of deep sclerectomy with trabeculotomy may provide an additional therapeutic approach whenever the prospect of success appears to be limited with deep sclerectomy alone.