Trabeculectomy versus combined trabeculotomy- trabeculectomy in pediatric glaucoma

摘要

Purpose: To compare outcomes between trabeculectomy and combined trabeculotomy-trabeculectomy in children with glaucoma. Methods: This was a retrospective, comparative study of 40 eyes in 33 patients with pediatric glaucoma: 17 eyes treated with trabeculectomy and 23 eyes treated with combined trabeculotomy-trabeculectomy. Both groups were treated with intraoperative mitomycin C. Success was defi ned as intraocular pressure (IOP) of 21 mm Hg or less and greater than 5 mm Hg with no additional glaucoma surgery. Results: Mean follow-up was 38.3 months. There was no signifi cant diff erence in mean IOP lowering between groups during the follow-up period. Log-rank survival analysis showed a signifi cantly higher success rate after combined surgery compared with trabeculectomy (P = .027). Treatment failures occurred in 5 patients with trabeculectomy and in 2 patients undergoing combined trabeculotomy-trabeculectomy. Failures resulted from increased IOP (n = 3) or hypotony (n = 4). There were no signifi cant diff erences in complications observed after surgery in both groups. Conclusion: Trabeculectomy and combined trabeculotomy-trabeculectomy with mitomycin C were equally eff ective at lowering average IOP in children. Combined trabeculotomy-trabeculectomy was associated with greater long-term success.