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

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.