Microcatheter-assisted circumferential trabeculotomy in primary congenital glaucoma

Area of Science:

• Ophthalmology
• Surgical Innovation
• Pediatric Glaucoma Management

Background:

• Primary congenital glaucoma (PCG) is a severe form of childhood glaucoma requiring effective surgical intervention.
• Traditional glaucoma surgeries can have significant complications, necessitating the exploration of safer, more effective techniques.
• Minimally invasive glaucoma surgeries (MIGS) are increasingly being explored for pediatric glaucoma.

Purpose of the Study:

• To evaluate the efficacy and safety of circumferential trabeculotomy performed with an illuminated microcatheter in patients with primary congenital glaucoma.
• To assess the reduction in intraocular pressure (IOP) and the need for antiglaucoma medications post-procedure.
• To monitor changes in corneal diameter and cup-to-disc ratio as secondary outcome measures.

Main Methods:

• A prospective, uncontrolled, interventional study involving 25 eyes of 25 patients diagnosed with PCG.
• Circumferential trabeculotomy was performed using a Glaucolight illuminated microcatheter.
• Intraocular pressure (IOP), medication use, corneal diameter, and cup-to-disc ratio were assessed over a 12-month follow-up period.

Main Results:

• The mean IOP significantly decreased from 27.28 mmHg preoperatively to 17.50 mmHg postoperatively (P < 0.001).
• A qualified success rate of 88% and a complete success rate of 76% were achieved within 18 months.
• No serious intraocular complications were reported during the follow-up period.

Conclusions:

• Circumferential trabeculotomy with an illuminated microcatheter is a safe and effective surgical option for lowering IOP in pediatric PCG.
• The procedure demonstrated a high rate of qualified and complete success, with a low failure rate.
• This technique represents a promising first-line surgical approach for managing primary congenital glaucoma in children.