Related Experiment Videos
Two-Year Outcomes of Visco-Circumferential Suture Trabeculotomy vs. Rigid Probe Hemi-Trabeculotomy in Late-Onset
Ahmed S Elwehidy1, Mostafa A Elwehidy1, Rasha M Elzeini1
1Department of Ophthalmology, Mansoura University, Mansoura, Egypt.
Objective:
To compare the 2-year outcomes of visco-circumferential suture trabeculotomy (VCST) versus rigid probe hemi-trabeculotomy (RPHT) in late-onset primary congenital glaucoma (LPCG).
Design:
A retrospective cohort study.
Subjects:
Late-onset primary congenital glaucoma patients who underwent VCST or RPHT.
Methods:
A retrospective chart review was conducted on LPCG patients who underwent VCST or RPHT between January 2014 and December 2023 and had a minimum of 2 years of postoperative follow-up.
Main Outcome Measures:
The primary outcome was surgical success, defined as complete success, intraocular pressure (IOP) ≤17 mmHg with ≥30% reduction from baseline, without antiglaucoma medications, and without anatomical evidence of glaucoma progression, or qualified success (meeting IOP criteria while requiring topical antiglaucoma medications [maximum of 3 agents]). The use of oral carbonic anhydrase inhibitors was considered a failure. Secondary outcomes included longitudinal changes in IOP, number of antiglaucoma medications, and incidence of complications.
Results:
A total of 79 eyes (79 patients) met the inclusion criteria (40 in the VCST group and 39 in the RPHT group). Baseline demographics were comparable between the 2 groups (mean age of 3.2 ± 0.3 years in the VCST vs. 3.1 ± 0.2 years in the RPHT, P = 0.42 years). At 24 months postoperatively, the overall success (complete and qualified) rate was significantly higher with VCST (95.00%) than with RPHT (84.66%; P = 0.04). Both procedures led to significant reductions in IOP from baseline, but eyes in the VCST group consistently exhibited lower mean IOP over the 24-month follow-up, with differences reaching statistical significance from the 18th month onward following Bonferroni correction (e.g., 13.7 ± 2.7 mmHg vs. 15.8 ± 3.6 mmHg at 18 months; P = 0.004). Transient hyphema was the most common complication that occurred in 66 of 79 eyes (83.5%) overall, more frequent in the VCST than in the RPHT group (relative risk: 1.24; 95% confidence interval: 1.01-1.53; P = 0.04).
Conclusions:
In this cohort, VCST achieved higher 2-year surgical success rates and more sustained IOP reduction compared with RPHT.
Financial Disclosure(S):
The authors have no proprietary or commercial interest in any materials discussed in this article.
Related Concept Videos
01:27Open Angle Glaucoma: Treatment
Drugs such as carbonic anhydrase inhibitors, α2- and...
01:28Angle Closure Glaucoma: Treatment
01:25Glaucoma: Overview