Rigid Probe Trabeculotomy Versus 360-Degree Catheter Trabeculotomy in Childhood Glaucoma

Abstract

Background/Objectives: This study aims to compare the effectiveness of traditional rigid probe trabeculotomy and 360-degree catheter trabeculotomy in treating childhood glaucoma, underlining the necessity of early surgical intervention. Methods: This retrospective cohort study, conducted at the University Eye Hospital Mainz, Germany, included 109 patients under 18 years with childhood glaucoma who underwent rigid probe trabeculotomy or 360-degree catheter trabeculotomy between January 2015 and February 2021. Results: A total of 151 eyes from 109 patients were included. The average IOP decreased significantly in both groups, with a greater reduction seen in the 360-degree catheter trabeculotomy group (mean reduction: 10.1 ± 8.7 mmHg; p < 0.001). In the rigid probe trabeculotomy group, the IOP reduction was 8.1 ± 9.0 mmHg (p < 0.001). The need for revision surgeries was lower in the 360-degree catheter trabeculotomy group. Conclusions: Both trabeculotomy techniques effectively reduced the intraocular pressure in childhood glaucoma. The 360-degree catheter trabeculotomy group demonstrated fewer revision surgeries compared to the rigid probe trabeculotomy group. However, there was no statistically significant difference in the IOP reduction between the groups. These findings indicate that while both methods are effective in managing the IOP in childhood glaucoma, the 360-degree catheter trabeculotomy may provide more favorable long-term results.

Keywords: childhood glaucoma; glaucoma surgery; trabeculotomy.

Figure 1

Comparison of the pre-operative IOP to the IOP at the last follow-up.