PRIMARY CONGENITAL GLAUCOMA;

Abstract

Objectives: To determine the outcome of trabeculotomy in patients presentingwith primary congenital glaucoma at a tertiary care hospital in Pakistan. Design: It wasa descriptive case series. Place and Duration of Study: This study was conducted at theDepartment of Ophthalmology, Allied Hospital Faisalabad over 3 years from January 2014to December 2016. Material and Methods: 45 consecutive children presenting with primarycongenital glaucoma were included after written informed consent. These children underwenttrabeculotomy. Outcome variable was frequency of successful treatment which was definedas persistent intraocular pressure below 20 mmHg without medication for at least six monthsand reduction or stabilization of cupping of the optic disc. A predesigned proforma was usedto record patient’s demographic details along with outcome variables. Results: The mean ageof the patients was 17.47±5.77 months. There were 28 (62.2%) male and 17 (37.8%) femalechildren with a male to female ratio of 1.6:1. It was bilateral in 37 (82.2%) patients. There wassignificant 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. Treatmentwas successful in 39 (86.7%) patients. There was no significant difference in the frequencyof successful treatment across age and gender groups. Conclusion: Trabeculotomy is aneasy to perform procedure with high success rate of 86.7% in children with primary congenitalglaucoma. The complications observed in the present series were related to surgical skill andtechnique and were successfully managed.