Randomized Trial on Illuminated-Microcatheter Circumferential Trabeculotomy Versus Conventional Trabeculotomy in Congenital Glaucoma

PURPOSE: To compare 1-year outcomes of illuminated microcatheter-assisted circumferential trabeculotomy (IMCT) vs conventional partial trabeculotomy (CPT) for primary congenital glaucoma (PCG). DESIGN: Randomized clinical trial. METHODS: Forty eyes of 31 patients with unilateral or bilateral primary congenital glaucoma aged less than 2 years were randomized to undergo IMCT (20 eyes) or CPT (20 eyes). Primary outcome measure was intraocular pressure (TOP) reduction. The success criterion was defined as IOP <= 12 mm Hg without and with anti glaucoma medications (absolute success and qualified success, respectively). RESULTS: The mean age of our study population was 8.35 +/- 1.2 months. The mean preoperative IOP was 24.70 +/- 3.90 mm Hg in the IMCT group and 24.60 +/- 3.31 mm Hg in the CPT group. Both groups were comparable with respect to preoperative IOP, corneal clarity, corneal diameter, vertical cup-to-disc ratio, and refractive error. In the IMCT group, 360-degree cannulation was achieved in 80% (16/20) of eyes. For the IMCT group and CPT groups, respectively, the absolute success rates were 80% (16/20) and 60% (12/20) (P <.001) and qualified success rates were 90% (18/20) and 70% (14/ 20) (P <.001). Both procedures produced a statistically significant reduction in IOP, and eyes undergoing IMCT achieved a lower IOP than CPT group eyes at 12 months follow-up (9.5 +/- 2.4 mm Hg and 11.7 +/- 2.1 mm Hg, respectively, P <.001). CONCLUSION: In primary congential glaucoma, illuminated microcatheter-assisted 360-degree circumferential trabeculotomy performed better than conventional partial trabeculotomy at 1 year follow-up and resulted in significantly lower IOP measurements. (C) 2017 Elsevier Inc. All rights reserved.