Abstract
Purpose To compare Ologen implant versus mitomycin-C (MMC) in combined trabeculotomy and trabeculectomy as a treatment of primary congenital glaucoma. Setting Sohag University Hospital, Egypt. Design A prospective comparative study. Methods Thirty-four eyes of twenty-one patients with primary congenital glaucoma were included in this study. All patients were subjected to preoperative evaluation including complete anterior segment examination under general anesthesia. The patients were divided into two groups: patients of the first group (group A) underwent combined trabeculotomy and trabeculectomy with Ologen implantation while those of the second group (group B) underwent combined trabeculotomy and trabeculectomy with MMC application. Results Postoperatively, the IOP in group A was as follows: 8 eyes developed IOP levels less than 14 mmHg (complete success), 3 eyes had levels between 14 and 16 mmHg (accepted result), 2 eyes had levels between 16 and 20 mmHg (guarded result), and only 2 eyes showed levels exceeding 20 mmHg (failed procedure), while in group B, 7 eyes showed complete success, 3 eyes had accepted result, 3 eyes had guarded result, and 2 eyes had failed procedure. Conclusion Ologen is a safe and effective adjuvant in combined trabeculotomy and trabeculectomy for treatment of primary congenital glaucoma.
Highlights
Congenital glaucoma (CG) is a major cause of blindness in children, despite its low incidence (1 : 10,000 births)
This study aims to verify the safety and efficacy of Ologen implant compared to MMC application as an adjuvant in the surgical treatment of primary congenital glaucoma
The inclusion criteria of the study were patients aged less than three years with primary congenital glaucoma as evidenced by history of lacrimation, photophobia, blepharospasm, and/or eye enlargement in additition to the signs of elevated IOP, increased corneal diameters, corneal haze, and/or increased cup-to-disc ratio, while the exclusion criteria included patients with secondary glaucoma; patients with other ocular pathologies, for example, congenital cataract; patients with previous ocular surgery including glaucoma surgery; and patients who could not adhere to the follow-up schedule
Summary
Congenital glaucoma (CG) is a major cause of blindness in children, despite its low incidence (1 : 10,000 births). It may be isolated (primary congenital glaucoma) or associated with other developmental anomalies, either systemic or ocular. The eyes with primary congenital glaucoma have an isolated maldevelopment of the trabecular meshwork not associated with other developmental ocular anomalies or ocular diseases that can raise intraocular pressure. It is the most common glaucoma of infancy, occurring in about 1 : 30,000 live births [1].
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