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Goniotomy vs external trabeculotomy for developmental glaucoma.

S D McPherson, D P Berry

    American Journal of Ophthalmology
    |April 1, 1983
    PubMed
    Summary
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    External trabeculotomy is a more successful initial surgical treatment for developmental glaucoma than goniotomy. While both procedures can manage intraocular pressure long-term, external trabeculotomy requires fewer repeat surgeries.

    Area of Science:

    • Ophthalmology
    • Pediatric Surgery

    Background:

    • Developmental glaucoma presents unique surgical challenges in pediatric patients.
    • Goniotomy and external trabeculotomy are established surgical options.
    • Comparative effectiveness data for initial management is crucial.

    Purpose of the Study:

    • To compare the success rates of external trabeculotomy versus goniotomy as a primary surgical intervention for developmental glaucoma.
    • To evaluate the long-term efficacy and need for repeat procedures for both surgical techniques.

    Main Methods:

    • A comparative study of patients with developmental glaucoma undergoing either external trabeculotomy or goniotomy.
    • Statistical analysis of initial surgical success rates.
    • Assessment of intraocular pressure control and number of subsequent surgical procedures required.

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    Main Results:

    • External trabeculotomy demonstrated a significantly higher success rate as a first operation (83%) compared to goniotomy (33%) (P = .003).
    • Both procedures effectively controlled intraocular pressure with multiple operations, but goniotomy required more repeat surgeries (31 vs. 13).
    • Failure rates within one year were higher for goniotomy (20/23) than for external trabeculotomy (6/8).

    Conclusions:

    • External trabeculotomy is a more effective initial surgical treatment for developmental glaucoma.
    • Goniotomy may necessitate more subsequent interventions to achieve adequate intraocular pressure control.
    • These findings support considering external trabeculotomy as a preferred first-line surgical approach.