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Outcomes of early versus delayed trabeculotomy for primary congenital glaucoma

Sebastião Cronemberger1, Artur W Veloso1, Pedro Lins1

  • 1Department of Ophthalmology and Otorhinolaryngology of the Federal University of Minas Gerais, Belo Horizonte, Brazil.

Acta Ophthalmologica
|December 20, 2022
PubMed

Insights

Early trabeculotomy (TROC) in primary congenital glaucoma (PCG) patients significantly reduces intraocular pressure (IOP) and abnormal axial length (AL) compared to delayed TROC.

Area of Science:

  • Ophthalmology
  • Pediatric Ophthalmology
  • Glaucoma Research

Background:

  • Primary congenital glaucoma (PCG) is characterized by elevated intraocular pressure (IOP), leading to abnormal eye growth.
  • Ab externo trabeculotomy (TROC) is a surgical procedure to manage PCG.
  • The timing of TROC may influence treatment outcomes in children with PCG.

Purpose of the Study:

  • To compare the efficacy of early versus delayed ab externo trabeculotomy (TROC) in managing primary congenital glaucoma (PCG).
  • To assess the impact of TROC timing on intraocular pressure (IOP) and ocular growth parameters.

Main Methods:

  • Retrospective comparison of children with PCG undergoing TROC at ≤6 months (early) versus >6 months (delayed).
  • Collected data on intraocular pressure (IOP), horizontal corneal diameter (HCD), central corneal thickness (CCT), and axial length (AL).
  • Follow-up assessments at 1, 3, 6, and 12 months post-surgery; AL compared to healthy controls.

Main Results:

  • Early TROC (n=33 eyes) showed a significantly lower incidence of abnormal axial length (AL) at 12 months (41.9%) compared to delayed TROC (n=37 eyes) (88.6%).
  • The mean IOP at 12 months post-surgery was lower in the early TROC group than in the delayed TROC group.
  • Each 1-mmHg increase in preoperative IOP correlated with a 0.25-mmHg increase in IOP at 12 months.

Conclusions:

  • Early TROC (≤6 months) is associated with better IOP control and a substantially reduced incidence of abnormal axial length (AL) in PCG patients.
  • Timely surgical intervention in PCG is crucial for mitigating long-term ocular abnormalities.
  • The findings support earlier surgical management for primary congenital glaucoma.
Abstract

Keywords:
axial lengthintraocular pressureprimary congenital glaucomatrabeculotomy

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