Journal of the Korean Ophthalmological Society 2003;44(4):876-881.
Published online April 1, 2003.
Clinical Observation of Combined Trabeculotomy and Trabeculectomy on Congenital Glaucoma.
Seung Joo Ha, Hee Bae Ahn, Kyung Won Yoo, Sae Heun Rho
Department of Ophthalmology, Dong-A University College of Medicine, Korea. shrho@daunet.donga.ac.kr
선천녹내장에서 섬유주절개술을 병용한 섬유주절제술의 임상적 고찰
하승주 ( Seung Joo Ha ) , 안희배 ( Hee Bae Ahn ) , 유경원 ( Kyung Won Yoo ) , 노세현 ( Sae Heun Rho )
Abstract
PURPOSE
To investigate the result of combined trabeculotomy and trabeculectomy as an initial operative treatment of congenital glaucoma. METHODS: We retrospectively reviewed the medical records of 8 patients (14 eyes) who were operated with combined trabeculotomy and trabeculectomy as an initial operative treatment of congenital glaucoma from October 13, 1998 to February 20, 2001. The mean age of patients was 1.2 years (ranging from 0.75 to 2 years) and the mean follow-up period was 12.4 months (12.3+/-8.18). We assessed the mean age at surgery, preoperative corneal diameter, preoperative and postoperative intraocular pressure, preoperative and postoperative C/D ratio, postoperative complications. RESULTS: The mean age at first surgery was 4.4 months (4.3+/-2.45), the mean postoperative intraocular pressure (IOP) at the end of follow-up period was 13.2+/-2.01mmHg, significantly lower than the mean preoperative IOP which was 25+/-5.23mmHg (P<0.05), the mean postoperative C/D ratio at the end of follow-up period was 0.38+/-0.14, significantly lower than the mean preoperative C/D ratio which was 0.55+/-0.15 (P<0.05), C/D ratio of 3 eyes among them was decreased by more than 0.2. The overall success rate was 71.4% (10 eyes) after single procedure. All the 4 failed eyes underwent trabeculectomy again and the IOP was well controled. The complications included hyphema(5 eyes), corneal edema (3 eyes), vitreous prolapse (3 eyes), posterior synechiae (2 eyes), and they were all resolved spontaneously. CONCLUSIONS: The combined surgery of trabeculotomy and trabeculectomy as an initial single procedure of congenital glaucoma lowered the IOP without serious complications.
Key Words: Congenital glaucoma;Combined trabeculotomy and trabeculectomy


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