Comparison of 360-Degree Circumferential Trabeculotomy and Conventional Trabeculotomy in Primary Pediatric Glaucoma Surgery: Part 1

Abstract

Purpose: To quantify the outcomes of a single circumferential trabeculotomy versus a single conventional trabeculotomy after 2 years of follow-up in patients who underwent primary pediatric glaucoma surgery.

Methods: This was a retrospective study of patients aged 1 day to 3 years who underwent primary pediatric glaucoma surgery. A total of 45 patients (79 eyes) were followed up for 2 years. There were two groups: the 360-degrees circumferential trabeculotomy with illuminated catheter group and the conventional trabeculotomy group.

Results: Mean age was 5.37 ± 6.32 months. There were 41 eyes with circumferential trabeculotomy and 38 eyes with conventional trabeculotomy. In the circumferential group, the technique could not be completed in 3 eyes (7.31%) because of severe canal malformations. Mean intraocular pressure and corneal diameter decreased in both groups postoperatively. At 2 years' follow-up, intraocular pressure (IOP) decreased, with 13.61 mm Hg in the circumferential group and 9.09 mm Hg in the conventional group. At 6 months postoperatively, corneal diameter decreased, with 0.52 mm in the circumferential group and 0.27 mm in the conventional group. Axial length remained the same.

Conclusions: Both procedures were successful, but circumferential trabeculotomy was better than the conventional procedure for lowering IOP, with an average of 4.52 mm Hg at 2 years' follow-up. The decrease in postoperative corneal diameter was also better in the circumferential group. The mean preoperative and postoperative axial lengths were similar in both groups; thus, the surgery did not influence this measurement in the studied cases. [J Pediatr Ophthalmol Strabismus. 2016;53(6):357-364.].