Gonioscopy-assisted transluminal trabeculotomy using an illuminated catheter for infantile primary congenital glaucoma. Case series

Purpose: To evaluate outcomes of trabeculectomy in terms of IOP control and its safety in terms of peroperativeand post-operative complications in Primary Congenital Glaucoma.Study Design: Interventional Case-Series.Place and Duration of Study: Helpers Eye Hospital, Quetta, from June 2017 to December 2018.Material and Methods: Thirty eyes of 17 patients were included in this case series after diagnosis of primarycongenital glaucoma. Patients with secondary congenital glaucoma due to trauma, surgery, inflammation, SturgeWeber Syndrome, Neurofibromatosis, cataract, uveitis, aphakia and pseudophakia were excluded from the study.Informed consent was taken from parents. Examination under anesthesia was done before surgery to recordpreoperative IOP, corneal diameter and anterior and posterior segment abnormalities. Primary trabeculectomywas done. Post-operative IOP and corneal diameter was recorded at 1st, 3rd and 6th month and every 6 monthsthereafter under general anesthesia. IOP at 12th month of surgery was the final outcome which was consideredsignificant if IOP was less than 21 mm Hg with stable corneal diameters.Results: Mean preoperative IOP was 25.8 mm Hg. Twenty-three (76.66%) eyes out of 30 eyes were consideredsuccessful with mean IOP of 15.3 mm Hg at last follow-up while 7 (23.33%) cases of failure were observed withpostoperative mean IOP of 27.71 mm Hg. These patients underwent additional surgeries to control IOP.Hyphema was the only complication observed in this study. Postoperative cataract developed in 5 eyes.Conclusion: Primary trabeculectomy is an effective operation and safe surgery for primary congenital glaucoma

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PRIMARY CONGENITAL GLAUCOMA;

The Professional Medical Journal ◽

10.29309/tpmj/2019.26.05.3482 ◽

2019 ◽

Vol 26 (05) ◽

Author(s):

Shabeer Ahmad Bhutto ◽

Naeem Akhtar Katpar ◽

Safdar Ali Abbasi

Keyword(s):

Case Series ◽

Congenital Glaucoma ◽

Slit Lamp ◽

Success Rates ◽

Interventional Study ◽

Primary Congenital Glaucoma ◽

Medical College ◽

Surgical Expertise ◽

Paediatric Ophthalmology ◽

Corneal Diameter

Objectives: The objective of this study is to compare the surgical outcome between modified trabeculotomy v/s combined modified trebeculotomy & trebeculectomy in primary congenital glaucoma. Study Design: Interventional case series. Setting: Paediatric Ophthalmology Department, Chandka Medical College. Period: June 2016 to June 2017. Method: This is a comparative study done to compare the outcomes of trabeculectomy and combined trabeculotomy and trabeculectomy. For comparison a prospective interventional study conducted in paediatric ophthalmology, Chandka Medical College during the duration of August 2014 to August 2016 was chosen. After examination by slit lamp and under anaesthesia, combined modified trabeculotomy and trabeculectomy was performed. Results: A total of 45 eyes of 29 patients with primary congenital glaucoma underwent modified trabeculotomy, 15 (51.72%) were males and 14 (48.28%) were females. Mean age of patients was 2.29 ± 3.70 years. On the other hand, combined modified trabeculotomy and trabeculectomy was performed in 22 eyes of 17 patients out of which 08 (47.06%) were males and 09 (52.94%) were females. Mean age ± standard deviation was 3.37 ± 4.40 years. Statistically significant reduction in IOP, corneal diameter and axial length were found. Conclusion: Combined trabeculotomy-trabeculectomy has better outcomes than trabeculotomy alone. It requires greater surgical expertise and time. Higher success rates are reported in previous studies due to dual outflow of aqueous humour.

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Combined trabeculotomy-trabeculectomy with antimetabolite and releasable suture: outcome with primary congenital glaucoma in a north Indian population

Nepalese Journal of Ophthalmology ◽

10.3126/nepjoph.v7i1.13161 ◽

2015 ◽

Vol 7 (1) ◽

pp. 16-25 ◽

Cited By ~ 7

Author(s):

S Dubey ◽

A Agrawal ◽

L Chauhan ◽

S Mukherjee ◽

G Douglas

Keyword(s):

Intraocular Pressure ◽

Mitomycin C ◽

Indian Population ◽

Case Series ◽

Congenital Glaucoma ◽

North Indian Population ◽

Success Rates ◽

Primary Congenital Glaucoma ◽

The Mean

Objective: To determine the surgical outcomes of combined trabeculotomy- trabeculectomy with mitomycin-C and releasable suture in children with primary congenital glaucoma (PCG) in a North Indian population. Design: Retrospective, interventional, consecutive, non-comparative case series. Materials and methods: The medical records of 137 eyes of 77 patients who underwent combined trabeculotomy- trabeculectomy with 0.2 mg/ml mitomycin C (MMC) either bilaterally (49 patients) or unilaterally (28 patients) between January 2004 and March 2012 were reviewed retrospectively. The main outcome measures were postoperative intraocular pressures, corneal clarity and diameter, duration of follow-up, success rate and complications. Results: The mean preoperative intraocular pressure reduced from 34 ± 7 mm Hg (range 15- 54 mm Hg) to 17 ± 7 mm Hg (range 5 - 32 mm Hg) with a mean reduction of 44 % (P < 0.001). The mean follow-up period was 24.4 ± 10.3 months (range 6 – 48 months). Complete success defined as intraocular pressure < 21 mm Hg without any medication and clinically stable glaucoma at last follow-up was achieved in 113 eyes (83 %) while a ‘quali¿ed success’ of intraocular pressure < 21 mm Hg with one medication was achieved in ten eyes (7 %). The Kaplan-Meier survival analysis revealed success rates (at ‘n’ months) of 90 % (6), 85 % (12), 82 % (24), 80 % (36) and 77 % (48). There were no signi¿cant intraoperative or postoperative complications.Conclusion: Primary combined trabeculotomy-trabeculectomy with mitomycin-C and releasable suture offers a viable surgical option in Northern Indian infants with primary congenital glaucoma. The use of 0.2 mg/ml mitomycin C for 2 minutes improves the overall success while the releasable suture decreases the risk of postoperative complications especially associated with the use of antimetabolites.

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Iris Tissue in Primary Congenital Glaucoma

Case Medical Research ◽

10.31525/ct1-nct04079725 ◽

2019 ◽

Author(s):

Keyword(s):

Congenital Glaucoma ◽

Primary Congenital Glaucoma

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Genetic analysis of patients with primary congenital glaucoma

International Ophthalmology ◽

10.1007/s10792-021-01815-z ◽

2021 ◽

Author(s):

Sedat Ava ◽

Atılım Armağan Demirtaş ◽

Mine Karahan ◽

Seyfettin Erdem ◽

Diclehan Oral ◽

...

Keyword(s):

Genetic Analysis ◽

Congenital Glaucoma ◽

Primary Congenital Glaucoma

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Ab interno 180-degree trabeculectomy with a dual blade in a patient with refractory primary congenital glaucoma

European Journal of Ophthalmology ◽

10.1177/11206721211010402 ◽

2021 ◽

pp. 112067212110104

Author(s):

Mehmet Talay Koylu ◽

Fatih Mehmet Mutlu ◽

Alper Can Yilmaz

Keyword(s):

Intraocular Pressure ◽

Female Patient ◽

Congenital Glaucoma ◽

Safe Procedure ◽

Primary Congenital Glaucoma ◽

History Of ◽

Kahook Dual Blade ◽

The Right ◽

Ab Interno

A 13-year-old female patient with refractory primary congenital glaucoma (PCG) in the right eye who had a history of multiple glaucoma operations underwent ab interno 180-degree trabeculectomy with the Kahook Dual Blade (KDB) targeting the nasal and inferior angles. On postoperative day 1, the intraocular pressure (IOP) of the right eye reduced from 43 to 15 mmHg while on medical therapy. The patient maintained this IOP level throughout the 6-month follow-up. Ab interno KDB trabeculectomy targeting both nasal and inferior angles may be an effective and safe procedure for the treatment of PCG even in eyes with a history of previously failed glaucoma procedures.

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