Microcatheter assisted Trabeculotomy for Primary Congenital Glaucoma After Failed Glaucoma Surgeries
Purpose: To evaluate the effectiveness of microcatheter assisted trabeculotomy (MAT) to treat primary congenital glaucoma after failed previous glaucoma surgeries. Materials and Methods: Retrospective, noncomparative, interventional case series conducted at Beijing Tongren Eye Center, China. Outcome measures were compared between 3 groups: successful and complete =330 degrees) MAT; successful and partial <330 degrees) MAT; or cases converted to traditional trabeculotomy when the Schlemm's canal could not be catheterized >180 degrees. Success was defined as final intraocular pressure 21 mm Hg, with (qualified success) or without (complete success) glaucoma medications. Results: In total, 74 eyes of 63 consecutive patients were included. MAT was performed in 50 eyes (67.6% Postoperative intraocular pressure and number of glaucoma drops (17.7+ 8.6 mm Hg, 0.6+ 1.2 medications) was significantly less than the preoperative values (35.3+ 7.2 mm Hg, 2.7+ 0.8 medications; P<0.001) Cumulative probabilities of qualified and complete success were 84.0% and 80.0% at 3 year follow up with no difference between complete and partial trabeculotomies. MAT was not successfully performed in 24 eyes (32.4% requiring conversion to traditional trabeculotomy and associated with greater incidence of previous surgeries (P<0.001) earlier age of disease onset (P=0.024) and worse corneal transparency (P=0.010) Cumulative probabilities of qualified and complete success were 37.0% and 29.2% at 3 year follow up. Conclusions: Both complete and partial MAT achieved significant pressure reduction in cases of primary congenital glaucoma with previous failed glaucoma surgeries in intermediate term.
Journal of glaucoma