One versus two simultaneous goniotomies as the initial surgical procedure for primary infantile glaucoma

Area of Science:

• Ophthalmology
• Pediatric Surgery

Background:

• Congenital glaucoma is a severe condition requiring effective intraocular pressure (IOP) management.
• Goniotomy is a surgical procedure to treat congenital glaucoma by incising the trabecular meshwork.

Purpose of the Study:

• To compare the efficacy of single versus double goniotomies in controlling IOP in infants with congenital glaucoma.
• To assess the impact of preoperative IOP and intraoperative sodium hyaluronate on surgical outcomes.

Main Methods:

• Seven infants with bilateral congenital glaucoma underwent a single goniotomy in one eye and two simultaneous goniotomies in the contralateral eye.
• Sodium hyaluronate (Healon) was used in eyes receiving two goniotomies and in some eyes receiving a single goniotomy.
• Intraocular pressure control was evaluated at 1 month and 1 year postoperatively.

Main Results:

• No significant difference in IOP control was observed between single and double goniotomy procedures at 1 month or 1 year.
• Successful IOP control was significantly associated with lower preoperative IOP.
• The use of sodium hyaluronate reduced postoperative hyphema incidence but did not affect IOP control.

Conclusions:

• Double goniotomy offers no significant advantage over single goniotomy for congenital glaucoma management.
• Preoperative IOP is a critical factor in predicting surgical success for congenital glaucoma.
• Sodium hyaluronate may be beneficial in reducing hyphema but does not influence IOP control efficacy.