Combined trabeculotomy and augmented trabeculectomy in primary congenital glaucoma

ABSTRACT

To evaluate the results of combined trabeculotomy and augmented trabeculectomy as a primary procedure on intraocular pressure and corneal clarity in uncomplicated congenital glaucoma. A case series. L.R.B.T Free Base Eye Hospital, Karachi, from January 2007 to December 2010. Twenty eyes of 14 consecutive children with primary congenital glaucoma who had primary trabeculotomy and augmented trabeculectomy were observed from January 2007 to December 2010 at LRBT Free Base Eye Hospital, Karachi Main outcome measures were pre-operative and postoperative intraocular pressure, corneal clarity and complications. Out of 14 patients, 9 patients [64.2%] were male and 5 patients [35.7%] were female with age ranging between 5 months to 6 years. Mean duration of follow-up was 8.25 months. Seventeen eyes [85%] showed improvement in corneal clarity from baseline at their last follow-up. Mean intraocular pressure decreased from 32 +/- 2.5 mmHg pre-operatively to 13 +/- 2.5 mmHg postoperatively at the last follow-up [p < 0.001]. Complete success [intraocular pressure < 20 mmHg] was obtained in 16 [80%] out of 20 eyes. Complications encountered were vitreous loss per-operatively while performing iridectomy in 1 eye [5%], shallow anterior chamber on the first postoperative day in 1 eye [5%] and hyphema in 1 eye [5%]. Combined trabeculotomy and augmented trabeculectomy for primary congenital glaucoma resulted in improvement in reduction of intraocular pressure as well as improvement in corneal clarity. Hence, combined trabeculotomy and augmented trabeculectomy is a safe and effective procedure for primary congenital glaucoma