Trabeculotomy in congenital glaucoma

Background: Congenital glaucoma is a potentially blinding disease that requ ires surgical therapy. This paper describes the outcome of trabeculotomy in primary congenital glaucoma. Methods: Thirty-nine eyes of 22 children with congenital glaucoma who underwent trabeculotomy with or without a simultan eous trabeculectomy between 1992 and 1997 were retrospectively analyzed. Re sults: Mean follow-up was 24.7+/-17.9 months. A mean of 1.3 operations per eye were performed. The mean IOP at the end of follow-up (n=39) was 17.7+/- 6.0 mmHg; in 8 eyes (20.5%) the IOP was >21 mmHg, in 31 eyes (79.5%) it was less than or equal to 21 mmHg. The mean difference between pretreatment IO P and IOP at the end of follow-up (n=39) was -10.5+/-9.4 mmHg (-37.2%). Suc cess rates were calculated: IOP was less than or equal to 21 mmHg in 36/39 eyes (92.3%) after 1/2 year of follow-up, in 25/27 eyes (92.6%) after 1 yea r, in 15/18 eyes (83.3%) after 2 years, in 8/12 (66.7%) eyes after 3 years, in 4/8 eyes (50%) after 4 years and in 4/4 (100%) eyes after 5 years of fo llow-up. Complications included hypotony (three eyes), subchoroidal bleedin g (one eye), detachment of Descemet's membrane (one eye) and macular pucker (one eye in which later mitomycin C was used). Visual acuity (VA) was test ed with various methods in 35 eyes. VA was within the normal nomogram range in 12 eyes and below the normal range in 23 eyes at the end of follow-up. Axial length measurements showed normalization according to the age nomogra m in 22 of 35 eyes. Conclusion: This study shows that trabeculotomy is an e ffective surgical procedure in congenital glaucoma with satisfactory succes s rates up to 5 years of follow-up.