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Glaucoma
Pediatrics

Early trabeculotomy for primary congenital glaucoma linked with reduced IOP

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Undergoing ab externo trabeculotomy (TROC) before 6 months of age is associated with reduced intraocular pressure (IOP) and substantially reduced incidence of abnormal axial length (AL) in patients with primary congenital glaucoma (PCG) at 12 months after surgery compared with undergoing TROC after 6 months of age, according to a study.

In this study, IOP, horizontal corneal diameter (HCD), central corneal thickness (CCT), and axial length (AL) were compared in children with PCG who underwent early TROC at age ≤ 6 months (n = 33 eyes) or delayed TROC at age >6 months (n = 37 eyes) at baseline and at 1-, 3-, 6- and 12-month follow-up visits.

The mean preoperative IOP was 15.97 ± 4.78/16.62 ± 4.85 mmHg and the 12-month postoperative IOP value was 9.77 ± 2.88/10.93 ± 4.83 mmHg.

Abnormal AL was found in 88.6% of eyes that underwent delayed TROC and only 41.9% of eyes that underwent early TROC.

Each 1-mmHg increase in preoperative IOP was associated with a 0.25-mmHg increase at 12 months, according to a multivariable analysis.

At postoperative month 12, the mean IOP of the delayed TROC group was on average 3.72 mmHg higher than that of the early TROC group.

Reference
Cronemberger S, Veloso AW, Lins P, et al. Outcomes of early versus delayed trabeculotomy for primary congenital glaucoma. Acta Ophthalmol. 2022;doi: 10.1111/aos.15310. Epub ahead of print. PMID: 36537172.

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