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Illuminated Microcatheter Passage Assisted Circumferential Trabeculotomy and Trabeculectomy (IMPACTT): An improved

Anil K Mandal1,2

  • 1Jasti V Ramanamma Children's Eye Care Centre, Hyderabad, India.

Seminars in Ophthalmology
|August 8, 2022
PubMed

Insights

A novel surgical technique, illuminated microcatheter passage assisted circumferential trabeculotomy and trabeculectomy (IMPACTT), shows promise for treating advanced primary congenital glaucoma (PCG). This improved procedure offers a safe and effective option for managing this serious pediatric eye condition.

Area of Science:

  • Ophthalmology
  • Pediatric Surgery
  • Glaucoma Research

Background:

  • Primary congenital glaucoma (PCG) is a severe pediatric eye condition requiring timely and effective surgical intervention.
  • Advanced stages of PCG present significant challenges in intraocular pressure (IOP) management and visual outcome.

Observation:

  • A case report details the surgical management of an infant diagnosed with advanced bilateral PCG.
  • The patient presented with elevated IOP (36 mmHg) and corneal enlargement (13.5 mm diameter) in both eyes.
  • The surgical procedure involved illuminated microcatheter passage assisted circumferential trabeculotomy and trabeculectomy (IMPACTT) performed in a single session.

Findings:

  • Postoperative IOP significantly reduced to 12 mmHg and 10 mmHg in the right and left eyes, respectively.
  • Corneal clarity was restored, with only residual Haab's striae observed.
  • Visual acuity, assessed using Teller acuity cards, reached 4 cycles/degree binocularly.

Implications:

  • IMPACTT demonstrates safety and efficacy in managing advanced PCG.
  • This technique may represent an advancement in surgical procedures for pediatric glaucoma.
  • Further studies are warranted to establish IMPACTT as a standard treatment for PCG.
Abstract

Keywords:
Combined trabeculotomy-trabeculectomyCongenital glaucomaIlluminated microcatheter passage assisted circumferential trabeculotomy and trabeculectomygoniotomytrabeculotomy

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