Combined trabeculotomy and trabeculectomy: outcome for primary congenital glaucoma in a West African population (original) (raw)
Related papers
ObjectiveTo report the long-term visual and surgical outcomes of combined trabeculotomy–trabeculectomy (CTT) as the initial glaucoma surgery in children with primary congenital glaucoma (PCG).MethodsProspective analysis of children who underwent primary CTT for PCG between January 2010 and December 2019. The main outcome measures were intraocular pressure (IOP) reduction, corneal clarity, success rate, complications, refractive errors and visual acuities (VA).ResultsA total of 98 eyes of 62 patients were enrolled. At last follow-up, mean IOP reduced from 22.68±3.99 mmHg to 9.75±3.88 mmHg (P<0.0001). Complete success rate was 91.6%, 88.4%, 84.7%, 71.6%, 59.7%, and 54.3%, respectively at first, second, fourth, sixth, eighth, and tenth year. Follow-up averaged 42.06±28.36 months. Preoperatively, 72 eyes (73.5%) had significant corneal haze, 84.7% among them achieved normal corneal transparency. Among the sight-threatening complications, endophthalmitis was encountered in one eye. My...
Management of primary congenital glaucoma by trabeculectomy in Nigeria
Annals of Tropical Paediatrics, 2008
Aim: To review the management of congenital glaucoma, bearing in mind the limited facilities available in developing countries. Methods: The medical records of children aged (3 years with primary congenital glaucoma seen at two teaching hospitals and one private eye hospital in Enugu, Nigeria over a 5-year period were reviewed retrospectively. All the children underwent trabeculectomy without use of anti-metabolites. Results: Fifty-seven eyes of 32 patients (5 unilateral, 26 bilateral) were reviewed. Pre-operatively, 63.2% of the eyes had a corneal diameter of 12-15 mm. After surgery, the number with corneal haziness decreased from 25 (43.8%) to 15 (26.4%) (p50.05). The mean (SD) pre-operative intra-ocular pressure (IOP) was 28.3 (7.5) mmHg and the mean post-operative IOP was 17 (5.6) mmHg (p50.001). Conclusions: When facilities for other treatment modalities are not available, primary trabeculectomy without the use of anti-metabolites can be employed to manage primary congenital glaucoma.
DOAJ (DOAJ: Directory of Open Access Journals), 2022
Purpose: To evaluate different pre-operative variables on the success of combined trabeculotomy-trabeculectomy (CTT) surgery in patients with primary congenital glaucoma (PCG) to predict those at higher risk for surgical failure and for proper parent counseling. Patients and Methods: Sixty-three eyes of patients with PCG were treated either with CTT without augmentation, or CTT augmented with mitomycin-C (0.2 mg/mL) in both subconjunctival space and under scleral flap for 3 minutes, or with CTT augmented with a collagen implant under both the scleral flap and the conjunctiva. Cases showed surgical failure was reported and evaluated in relation to different pre-operative variables. Results: Complete success (IOP ≤21 mmHg) was achieved in 52 cases (82.5%). Cumulative success probability was calculated using Kaplan-Meier survival analysis, proving that higher pre-operative intraocular pressure (IOP) was associated with higher failure rates (28.6% for pre-operative IOP ≥30 mmHg versus 4.8% for IOP <30 mmHg), with P value = 0.007. Conclusion: CTT is an effective surgical intervention in PCG patients without sight threatening complications. Univariate survival analysis showed higher rates of surgical failure in patients with higher pre-operative IOP, while other pre-operative variables were irrelevant.
Clinical Ophthalmology, 2022
Purpose: To evaluate different pre-operative variables on the success of combined trabeculotomy-trabeculectomy (CTT) surgery in patients with primary congenital glaucoma (PCG) to predict those at higher risk for surgical failure and for proper parent counseling. Patients and Methods: Sixty-three eyes of patients with PCG were treated either with CTT without augmentation, or CTT augmented with mitomycin-C (0.2 mg/mL) in both subconjunctival space and under scleral flap for 3 minutes, or with CTT augmented with a collagen implant under both the scleral flap and the conjunctiva. Cases showed surgical failure was reported and evaluated in relation to different pre-operative variables. Results: Complete success (IOP ≤21 mmHg) was achieved in 52 cases (82.5%). Cumulative success probability was calculated using Kaplan-Meier survival analysis, proving that higher pre-operative intraocular pressure (IOP) was associated with higher failure rates (28.6% for pre-operative IOP ≥30 mmHg versus 4.8% for IOP <30 mmHg), with P value = 0.007. Conclusion: CTT is an effective surgical intervention in PCG patients without sight threatening complications. Univariate survival analysis showed higher rates of surgical failure in patients with higher pre-operative IOP, while other pre-operative variables were irrelevant.
Success of trabeculotomy in patients with congenital glaucoma operated on within 3 months of birth
Eye, 2006
Aims To determine the efficacy and safety of trabeculotomy in congenital glaucoma patients operated on within first 3 months of birth. Methods A total of 36 eyes of 24 patients with congenital glaucoma, who underwent primary trabeculotomy within first 3 months of birth were included. Preoperative and postoperative intraocular pressures (IOP), corneal clarity, diameter, axial length, success rates, and complications were evaluated in this study.
Trabeculectomy in Congenital Glaucoma; Experience in Helpers Eye Hospital Quetta
Pakistan Journal of Ophthalmology, 2020
Purpose: To evaluate outcomes of trabeculectomy in terms of IOP control and its safety in terms of peroperativeand post-operative complications in Primary Congenital Glaucoma.Study Design: Interventional Case-Series.Place and Duration of Study: Helpers Eye Hospital, Quetta, from June 2017 to December 2018.Material and Methods: Thirty eyes of 17 patients were included in this case series after diagnosis of primarycongenital glaucoma. Patients with secondary congenital glaucoma due to trauma, surgery, inflammation, SturgeWeber Syndrome, Neurofibromatosis, cataract, uveitis, aphakia and pseudophakia were excluded from the study.Informed consent was taken from parents. Examination under anesthesia was done before surgery to recordpreoperative IOP, corneal diameter and anterior and posterior segment abnormalities. Primary trabeculectomywas done. Post-operative IOP and corneal diameter was recorded at 1st, 3rd and 6th month and every 6 monthsthereafter under general anesthesia. IOP at 12t...
Eye, 2006
Purpose To report the safety and efficacy of combined trabeculotomy and trabeculectomy (CTT) in advanced primary developmental glaucoma with corneal diameter 14 mm or more. Patients and Methods A total of 74 (121 eyes) consecutive patients aged 3 days-100 months (median, 10 months) with advanced developmental glaucoma were included. Primary CTT was performed by a single surgeon at a tertiary eye care centre in India over a 13-year period. The main outcome measures were changes in and final levels of intraocular pressure (IOP), corneal clarity, visual acuity, and refractive status. Results Mean preoperative IOP was 29.477.6 mmHg (range, 10-56 mmHg) and mean postoperative IOP was 15.576.6 mmHg (range, 6-38 mmHg) (Po0.0001) with percentage reduction of 44.5727.1. Kaplan-Meier survival analysis revealed 3-, 6-, 9-, 12-, 24-, 48-, and 72-month success rates of 86.5, 80.5, 78.1, 75.5, 71.1, and 60.5%, respectively. Majority (80.5%) of the patients were myopes with mean spherical equivalent of 5.874.5D (range, 0.75-22.0D). Using various ageappropriate testing procedures, at the final follow-up visit, 14 patients (41.2%) had age-appropriate normal visual acuity and 20 patients (58.8%) had subnormal visual acuity. Best-spectacle-corrected visual acuity of X20/60 was achieved in seven patients (26.9%). There were no sightthreatening intraoperative and postoperative complications.
Clinical Ophthalmology, 2012
To quantify the long-term outcomes of congenital glaucoma and surgical success rates following pseudo 360-degree trabeculotomy surgery at Children's Medical Center in Dallas. Patients and methods: An International Classification of Diseases (ICD-9) database was utilized for a retrospective chart review. Thirty-eight eyes of 24 who underwent primary trabeculotomy with a pseudo 360-degree technique between June 1, 1992 and December 31, 2005 were studied. Results: Mean age at the time of trabeculotomy was 11.1 ± 3.0 months, with seven eyes operated on after 1 year of age. Mean follow-up was 85.1 ± 9.0 months. Mean intraocular pressure (IOP) at the time of glaucoma diagnosis was 32.7 ± 1.1 mmHg, and final mean IOP for all eyes (after trabeculotomy and any additional surgery and/or glaucoma medications) was 17.9 ± 0.8 mmHg.
Long-term follow up of primary trabeculectomy for infantile glaucoma
British journal of …, 1996
Background-The treatment for infantile glaucoma is surgical. Treatment options include goniotomy, trabeculotomy, combined trabeculotomy-trabeculectomy, and trabeculectomy. Methods-Patients who had a follow up of 5 years or longer after primary trabeculectomy were examined to determine the long term stability in infantile glaucoma. Results-In eyes with primary infantile glaucoma 92.3% achieved control of their glaucoma with a single trabeculectomy; 100% achieved control with two trabeculectomies; 85.7% of eyes with secondary infantile glaucoma achieved control with a single trabeculectomy. There were no serious complications experienced in either group. Conclusion-Primary trabeculectomy is a safe and successful operation for infantile glaucoma.