Trabeculotomy in late onset congenital glaucoma

Area of Science:

• Ophthalmology
• Pediatric Surgery
• Glaucoma Research

Background:

• Congenital glaucoma in children requires effective surgical interventions.
• Traditional trabeculotomy has limitations in managing pediatric glaucoma.
• Late-onset congenital glaucoma presents unique treatment challenges.

Purpose of the Study:

• To evaluate a modified trabeculotomy technique for primary glaucoma treatment in children over one year of age.
• To assess the efficacy and safety of this modified surgical approach.

Main Methods:

• A modified trabeculotomy procedure involving excision of tissue in the deep scleral bed under the scleral flap was performed.
• The modification aimed to exteriorize Schlemm's canal and thin scleral tissue without entering the anterior chamber.
• The study included 7 eyes in 5 children aged 1-9 years.

Main Results:

• Intraocular pressure remained below 20 mmHg without medication in 6 out of 7 eyes for 18 months to 4 years.
• One eye required topical epinephrine after 2 years to maintain target pressure.
• No complications were observed, with 4 eyes showing diffuse conjunctival filtering blebs.

Conclusions:

• The modified trabeculotomy technique is a potentially effective and safe primary surgical option for children with late-onset congenital glaucoma.
• This approach may offer a favorable alternative to traditional methods, with good long-term pressure control and minimal complications.