Congenital glaucoma with corneal cloudiness treated by thermal sclerostomy

Thermal sclerostomy (the Scheie procedure) was performed on nine eyes with congenital glaucoma and corneal cloudiness. The intraocular pressure was controlled and the cornea cleared in six eyes, though two required a second sclerostomy for success. In two of the remaining three eyes the intraocular pressure did not fall to normal levels, but the cornea cleared sufficiently to permit goniotomy, which was successful in each case. The remaining eye failed to respond to two sclerostomies. Thermal sclerostomy is recommended as a primary form of treatment in cases of congenital glaucoma in which corneal opacification makes goniotomy unsafe. While trabeculotomy is useful in these circumstances and may be the procedure of choice in many cases, thermal sclerostomy is recommended for the surgeon who is more familiar with this technique and for cases in which distortion of the anterior chamber angle is expected to preclude trabeculotomy or goniotomy.