PRIMARY CONGENITAL GLAUCOMA;

OUTCOME OF TRABECULOTOMY.

Abstract

Objectives: To determine the outcome of trabeculotomy in patients presenting
with primary congenital glaucoma at a tertiary care hospital in Pakistan. Design: It was
a descriptive case series. Place and Duration of Study: This study was conducted at the
Department of Ophthalmology, Allied Hospital Faisalabad over 3 years from January 2014
to December 2016. Material and Methods: 45 consecutive children presenting with primary
congenital glaucoma were included after written informed consent. These children underwent
trabeculotomy. Outcome variable was frequency of successful treatment which was defined
as persistent intraocular pressure below 20 mmHg without medication for at least six months
and reduction or stabilization of cupping of the optic disc. A predesigned proforma was used
to record patient’s demographic details along with outcome variables. Results: The mean age
of the patients was 17.47±5.77 months. There were 28 (62.2%) male and 17 (37.8%) female
children with a male to female ratio of 1.6:1. It was bilateral in 37 (82.2%) patients. There was
significant improvement in the mean intraocular pressure (12.69±2.12 vs. 25.09±4.52 mmHg;
p<0.00001), horizontal corneal diameter (11.96±1.49 vs. 14.87±2.03mm; p<0.00001),
axial length (20.16±2.51 vs. 20.69±2.37mm; p=0.0002) and cup-disc ratio (0.30±0.15 vs.
0.51±0.19; p<0.00001) from baseline at 6 months follow-up after trabeculotomy. Treatment
was successful in 39 (86.7%) patients. There was no significant difference in the frequency
of successful treatment across age and gender groups. Conclusion: Trabeculotomy is an
easy to perform procedure with high success rate of 86.7% in children with primary congenital
glaucoma. The complications observed in the present series were related to surgical skill and
technique and were successfully managed.