Goniotomy Versus Circumferential Trabeculotomy with an Illuminated Microcatheter in Congenital Glaucoma

Purpose: To compare circumferential trabeculotomy performed with an illuminated microcatheter with standard goniotomy for the treatment of congenital glaucoma.

Methods: The short-term results of catheter-assisted trabeculotomy with an illuminated microcatheter were retrospectively compared with those of goniotomy in patients treated for congenital glaucoma. Success with either approach was defined as an intraocular pressure (IOP) <21 mm Hg with at least a 30% reduction from preoperative pressure levels at 12-month follow-up. Complete success was defined when the target IOP levels were reached without the use of antiglaucoma medication, and qualified success was defined when antiglaucoma drops were required to meet this level of IOP.

Results: A total of 24 eyes of 20 patients were included. Microcatheter-assisted circumferential trabeculotomy demonstrated a 91.6% qualified and 83.3% unqualified success rate with 12-month follow-up that exceeded the 53.8% qualified and 46.2% unqualified success rate of conventional goniotomy.

Conclusions: In congenital glaucoma, during the first year after surgery, trabeculotomy performed with an illuminated microcatheter appears to be more effective than ab interno goniotomy. No complications were seen in either group; however, the follow-up was relatively short.