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Long-term results of viscotrabeculotomy in congenital glaucoma: comparison to classical trabeculotomy.

Tamcelik N, Ozkiris A

Istanbul University Cerrahpasa Medical Faculty, Istanbul, Turkey. ntamcelik@superonline.com

BACKGROUND: To evaluate the outcomes of viscotrabeculotomy in patients with primary congenital glaucoma and to compare the success and complications rates with classical trabeculotomy. PATIENTS AND METHODS: Patients who were selected for this study had all presented with primary congenital glaucoma before the age of 12 months, and they were divided into two groups. Group 1 consisted of 58 eyes of 34 patients who underwent viscotrabeculotomy, and group 2 consisted of 51 eyes of 30 patients who underwent classical trabeculotomy. Pre-and postoperative intraocular pressures (IOPs), mean antiglaucoma medication, mean corneal diameter, success rates, intra-and postoperative complications were compared between two groups. RESULTS: Mean preoperative IOP was 30.6 (SD 5.7) mm Hg in group 1 and 29.9 (4.9) mm Hg in group 2. At the last visits, it was 16.2 (2.9) mm Hg and 17.3 (2.8) mm Hg, respectively (p<0.001). The mean number of antiglaucoma medications used after surgery was significantly lower in group 1 (p<0.05). At the last visits, the success rates of group 1 and group 2 were 91.3% and 68.6%, respectively, and the difference was statistically significant (p = 0.02). The most common early postoperative complication was transient IOP elevation in group 1 and hyphaema in group 2 (for each, p<0.001). CONCLUSION: Use of viscoelastic materials during trabeculotomy may increase the success rate of the procedure by prevention of postoperative haemorrhage, adhesion of the incision lips or fibroblastic proliferation.

Published 24 December 2007 in Br J Ophthalmol, 92(1): 36-9.
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