An illuminated microcatheter for 360-degree trabeculectomy in congenital glaucoma: A retrospective case series

PURPOSE To evaluate the efficacy of achieving a 360 degrees ab externo trabeculectomy using an illuminated ophthalmic microcatheter for the treatment of primary congenital glaucoma. METHODS This retrospective, consecutive case series included 16 eyes of 10 patients <= 3 years of age at the time of surgery and diagnosed with primary congenital glaucoma. All patients underwent a trabeculectomy via microcatheter with the intent of catheterizing the full circumference of Schlemm's canal and rupturing the entire canal in a single procedure. The main outcome measure was the success rate of achieving a complete 360 degrees as compared to a partial trabeculectomy. Secondary outcome measures included intraocular pressure (TOP), glaucoma medication usage, and adverse events. Clinical examination data are reported up to 12 months postoperatively. RESULTS Of 16 eyes included, 12(75%) achieved a complete 360 degrees trabeculectomy using the microcatheter; 4 of 16 eyes (25%) achieved a partial trabeculectomy. For all treated eyes the postoperative reduction in TOP from baseline was statistically significant at the 1-, 3-, and 6-month follow-up visits (p < 0.001). At 6 months, IOP was significantly lower in the complete as compared to the partial trabeculectomy cohort (p = 0.03). CONCLUSIONS A complete or partial trabeculectomy was safely completed in eyes with primary congenital glaucoma using a microcatheter with an illuminated, atraumatic tip. (J AAPOS 2010;14:412-416)