Clinical experience of trabeculotomy for the surgical treatment of aniridic glaucoma

The purpose of this study is to determine the efficacy of initial trabeculotomy in the patient with aniridic glaucoma.

Clinical charts were reviewed.

Twenty-nine eyes of 16 patients with aniridia were studied.

Glaucoma surgery was performed. As an initial procedure, trabeculotomy was performed in 12 eyes, other surgery was performed in 17 eyes (trabeculectomy, 5; goniotomy, 5; other, 7).

Success was defined as an intraocular pressure (IOP) of 21 mmHg or lower, and no further surgery was performed.

Ten (83%) of 12 eyes obtained IOP control after first (6 eyes) or second (4 eyes) trabeculotomy with a mean follow-up period of 9.5 years. Five eyes maintained visual acuity of 20/40 to 20/200. No serious complications were found after trabeculotomy. Three (18%) of 17 eyes were controlled with the first glaucoma surgery other than trabeculotomy (goniotomy, trabeculectomy, trabeculectomy combined with trabeculotomy, and Molteno implant). Good IOP control was obtained in 8 (47%) of 17 eyes after several surgeries with a mean follow-up period of 10.4 years. Four of 17 eyes became phthisical.

This study suggests that trabeculotomy is the preferred initial operation for uncontrolled glaucoma with aniridia.