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

Sarkisian, Steven R.

doi:10.1016/j.jaapos.2010.07.010

Cited by 94 publications

(75 citation statements)

References 17 publications

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“…This is consistent with data comparing goniotomy and 360-degree circumferential trabeculotomy. Prior studies have cited a success rate ranging from 81-92% with circumferential trabeculotomy for primary congenital, glaucoma showing that it is equal to or better than goniotomy at gaining IOP control 1,3,4,7,8 . This is particularly notable when one considers the fact that goniotomy is mainly performed in eyes with less severe glaucoma and clear corneas.…”

Section: Discussionmentioning

confidence: 99%

Comparison of 360-degree versus traditional trabeculotomy in pediatric glaucoma

Lim

Neely

Wang

et al. 2015

Journal of American Association for Pediatric Ophthalmology and

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Section: Discussionmentioning

confidence: 99%

Comparison of 360-degree versus traditional trabeculotomy in pediatric glaucoma

Lim

Neely

Wang

et al. 2015

Journal of American Association for Pediatric Ophthalmology and

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“…15,16 Briefly, following a conjunctival peritomy, the Schlemm's canal was exposed by either scleral cut down under a superficial scleral flap or direct unroofing via a deep scleral flap. In those with previous surgeries, the site of sclera flap was located laterally to previous flap (or bleb if existed) for at least 60°to avoid the possible damage of Schlemm's canal in previous surgeries.…”

Section: Surgical Procedures and Postoperative Carementioning

confidence: 99%

“…14 Recently, it has been reported that a complete or partial trabeculotomy was safely completed in eyes with childhood glaucoma with the assistance of an illuminated microcatheter, and that it provided significant IOP-lowering effects. 15,16 To date, the feasibility and effect of microcatheter-assisted trabeculotomy in eyes with previous failed angle surgeries have not been reported to our knowledge. In this study, we report surgical outcomes of microcatheter-assisted trabeculotomy in patients with PCG following failed angle surgeries, compared with those with no previous angle surgery.…”

Section: Introductionmentioning

confidence: 99%

Outcomes of microcatheter-assisted trabeculotomy following failed angle surgeries in primary congenital glaucoma

Shi

Wang

Yin

et al. 2016

Eye

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Purpose To report surgical outcomes of microcatheter-assisted trabeculotomy following failed angle surgeries, and compare those with no previous angle surgery, in primary congenital glaucoma (PCG). Methods The early postoperative (12 months) results of 42 eyes of 36 patients who underwent microcatheter-assisted trabeculotomy by single surgeon for PCG were retrospectively analyzed. Group 1, 20 eyes of 16 patients, had no previous angle surgery. Group 2, 22 eyes of 20 patients, had one or two previous failed angle surgeries. Success was defined as an intraocular pressure (IOP) o21 mm Hg with at least a 30% reduction from preoperative IOP with (qualified success) or without (complete success) the use of antiglaucoma medication. Results Mean IOP decreased from 31.5 ± 7.2 mm Hg on 3 (median, range: 1-5) medications in Group 1 and 34.6 ± 7.3 mm Hg on 3 (median, range: 1-4) medications in Group 2 preoperatively to 15.6 ± 3.1 mm Hg on 0 (median, range: 0-4) medications in Group 1 and 16.0 ± 4.6 mm Hg on 0 (median, range: 0-2) medications in Group 2 postoperatively at 12 months (both Po0.001), respectively. The mean percentage of IOP reduction from preoperative to last postoperative visit was 46.0 ± 20.1% in Group 1 and 45.5 ± 25.0% in Group 2, P = 0.947. Qualified and complete successes were comparable between Group 1 and Group 2 (qualified success: 90.0% vs 77.3%, P = 0.294; complete success: 78.9% vs 77.3%, P = 0.853). Complications were minimal. Conclusions Microcatheter-assisted trabeculotomy achieved significant pressurelowering effects with a reduction in medication use in PCG, and it represents a reasonable choice of initial and repeat surgical treatment for PCG.

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“…The introduction of an illuminated microcatheter, first used in adult canaloplasty surgery, as a substitute for the suture, improved the safety of the procedure. 29 The 1990s were also remarkable for the widespread introduction of anti-scarring agents in trabeculectomy surgery to improve success. 30,31 As a primary or secondary procedure in children, trabeculectomy was still associated with failure in many cases due to excessive scarring.…”

Section: Historymentioning

confidence: 99%

“…This incremental stepwise approach employs multiple surgeries, and there is a tension between the need for repeated anaesthetics to allow sufficient monitoring and treatment of the disease and the concern for possible deleterious effects on young brain development. 65,66 In this regard, the recent evolution of circumferential (3601) trabeculotomy using an illuminated microcatheter, 29,67 instead of a suture, may offer a significant improvement to the approach to the paediatric angle in the 21st century. It potentially allows treatment of 3601 of the angle in a single surgical episode, confidence that the TM has been ruptured to connect Schlemm canal with the AC, and is not associated with prolene suture complications such as subretinal positioning from misdirection.…”

Section: Angle Surgerymentioning

confidence: 99%