Purpose: To evaluate the long-term efficacy and safety of circumferential trabeculotomy (CT) in the treatment of primary congenital glaucoma (PCG). Methods: Retrospective, single-institutional case series of CT performed for PCG in years 1997-2016. The surgery could be completed in 42 out of 65 eyes (65%) intended for CT, and 39 of them were included in the study. A follow-up examination was performed in 2017. Success was defined as intraocular pressure ≤ 16 mmHg without (complete) or with (qualified) glaucoma medication. Results: Complete success was obtained in 33/39 eyes (85%), qualified success in 34/39 eyes (87%). Of the 39 eyes with CT, 4 eyes (10%) needed additional surgery. Median follow-up time was 120 months (range, 19-245 months). Median pre-and postoperative IOP were 26.0 mmHg (range, 10-41 mmHg) and 11.0 mmHg (range, 8-19 mmHg), respectively (p < 0.001). Cup-disc ratio was ≥0.5 in 82% at baseline, at follow-up in 9%. The median distance corrected visual acuity at follow-up was logMAR 0.06 (range, À0.2 to 1.1). Median number of glaucoma medication at follow-up was 0 (range, 0-2), at baseline 1.0 (range, 0-2). No serious complications were noted. Conclusion: Circumferential trabeculotomy is an efficacious, safe and medication saving surgical treatment for PCG in the long term. After a median followup of 10 years (120 months), the morphological status of the optic nerve was either normalized or stabilized, and the visual acuity overall well preserved.

PurposeA comparison of the safety and efficacy of the MicroShunt versus trabeculectomy in the early postoperative period, with a particular focus on hypotony.MethodsIn this registry study, we evaluated 200 eyes of 200 glaucoma patients who underwent filtration surgery at Oslo University Hospital between 2017 and 2021. Of these patients, 100 had a Preserflo MicroShunt (Santen) implantation and 100 had a trabeculectomy procedure. The patients were examined per standard hospital protocol after filtration surgery. Data were extracted from the 4‐ and 8‐week visits. We defined hypotony as intraocular pressure (IOP) < 6 mmHg.ResultsThe mean preoperative IOP was 20.6 ± 7.1 mmHg in the MicroShunt group and 21.6 ± 7.1 mmHg in the trabeculectomy group, and the patients used a mean of 3.0 ± 0.9 and 3.1 ± 0.9 glaucoma medications, respectively. After 8 weeks, IOP was reduced to 10.4 ± 5.4 mmHg and 11.3 ± 4.6 mmHg, respectively (p = 0.23). During the early postoperative period, hypotony was registered in 63% of the MicroShunt patients and in 21% of the patients in the trabeculectomy group (p < 0.001); and 11% and 1%, respectively, of the patients developed choroidal detachments (p < 0.003). One patient in the MicroShunt group required reoperation due to hypotony.ConclusionsIn this registry study, we found that the Preserflo MicroShunt and trabeculectomy had equally satisfactory IOP‐lowering effects during the early postoperative period. In this same period, a high number of patients in the MicroShunt group developed hypotony.

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