Long-term surgical and visual outcomes in primary congenital glaucoma: 360 degrees trabeculotomy versus goniotomy

M E Mendicino; M G Lynch; A Drack; Allen D Beck; T Harbin; Z Pollard; M A Vela; Michael J Lynn

doi:10.1067/mpa.2000.106201

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Long-term surgical and visual outcomes in primary congenital glaucoma: 360 degrees trabeculotomy versus goniotomy

Journal article

Peer reviewed

Long-term surgical and visual outcomes in primary congenital glaucoma: 360 degrees trabeculotomy versus goniotomy

M E Mendicino, M G Lynch, A Drack, Allen D Beck, T Harbin, Z Pollard, M A Vela and Michael J Lynn

Journal of AAPOS, Vol.4(4), pp.205-210

08/2000

DOI: 10.1067/mpa.2000.106201

PMID: 10951295

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Abstract

To compare the visual outcome and refractive status of children with primary congenital glaucoma who underwent 360 degrees trabeculotomy or goniotomy as an initial surgical procedure. This retrospective study describes 24 eyes (15 patients) with primary congenital glaucoma that underwent 360 degrees trabeculotomy as the initial procedure and 40 eyes (23 patients) that underwent goniotomy as the initial procedure. Inclusion criteria were: (1) diagnosis of primary congenital glaucoma and initial angle surgery before 1 year of age, (2) no other ocular or systemic diseases, (3) 360 degrees trabeculotomy or goniotomy as the first surgical procedure, and (4) ability to obtain an Allen or Snellen visual acuity. A postoperative vision of 20/50 or better was considered good. Surgical success was defined as an intraocular pressure (IOP) less than 22 mm Hg with or without medication and without evidence of a progressive optic neuropathy. The IOP was successfully controlled in 92% of eyes in the trabeculotomy group and in 58% of eyes in the goniotomy group (P =.004). Of eyes in the trabeculotomy group, 79% had vision of 20/50 or better compared with 53% in the goniotomy group (P =.03). High myopia was more prevalent in the goniotomy group, but this difference was not statistically significant (P =.16). A poor visual outcome was associated with failure of the angle surgery or poor compliance with follow-up and amblyopia therapy. For primary congenital glaucoma, 360 degrees trabeculotomy is a highly effective procedure that results in excellent pressure control and is at least as successful as multiple standard procedures. In this study, 360 degrees trabeculotomy resulted in better vision than what is reported in the literature for standard angle procedures.

Follow-Up Studies

Intraocular Pressure

Humans

Infant

Male

Treatment Outcome

Glaucoma - surgery

Visual Acuity

Glaucoma - congenital

Anterior Chamber - pathology

Anterior Chamber - surgery

Female

Glaucoma - pathology

Retrospective Studies

Infant, Newborn

Trabeculectomy - methods

Details

Title: Subtitle: Long-term surgical and visual outcomes in primary congenital glaucoma: 360 degrees trabeculotomy versus goniotomy
Creators: M E Mendicino - Department of Ophthalmology, Emory University School of Medicine, Rollins School of Public Health, Emory University, Atlanta, GA30322, USA
M G Lynch
A Drack
Allen D Beck
T Harbin
Z Pollard
M A Vela
Michael J Lynn
Resource Type: Journal article
Publication Details: Journal of AAPOS, Vol.4(4), pp.205-210
DOI: 10.1067/mpa.2000.106201
PMID: 10951295
NLM abbreviation: J AAPOS
ISSN: 1091-8531
eISSN: 1528-3933
Publisher: Elsevier Inc; United States
Grant note: P30 EY06360 / NEI NIH HHS
Language: English
Date published: 08/2000
Academic Unit: Stead Family Department of Pediatrics; Ophthalmology and Visual Sciences
Record Identifier: 9983979926002771

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