An illuminated microcatheter for 360-degree trabeculotomy [corrected] in congenital glaucoma: a retrospective case series

Abstract

Purpose: To evaluate the efficacy of achieving a 360° ab externo trabeculotomy [corrected] using an illuminated ophthalmic microcatheter for the treatment of primary congenital glaucoma.

Methods: This retrospective, consecutive case series included 16 eyes of 10 patients ≤ 3 years of age at the time of surgery and diagnosed with primary congenital glaucoma. All patients underwent a trabeculotomy [corrected] via microcatheter with the intent of catheterizing the full circumference of Schlemm's canal and rupturing the entire canal in a single procedure. The main outcome measure was the success rate of achieving a complete 360° as compared to a partial trabeculotomy. [corrected] Secondary outcome measures included intraocular pressure (IOP), glaucoma medication usage, and adverse events. Clinical examination data are reported up to 12 months postoperatively.

Results: Of 16 eyes included, 12 (75%) achieved a complete 360° trabeculotomy [corrected] using the microcatheter; 4 of 16 eyes (25%) achieved a partial trabeculotomy. [corrected] For all treated eyes the postoperative reduction in IOP from baseline was statistically significant at the 1-, 3-, and 6-month follow-up visits (p < 0.001). At 6 months, IOP was significantly lower in the complete as compared to the partial trabeculotomy [corrected] cohort (p = 0.03).

Conclusions: A complete or partial trabeculotomy [corrected] was safely completed in eyes with primary congenital glaucoma using a microcatheter with an illuminated, atraumatic tip.