Shabeer Ahmed Bhutto, Syed Shujaat Ali Shah, Syed Imtiaz Ali Shah.
Surgical Outcome of Modified Trabeculotomy in primary Congenital Glaucoma patients.
Ophthalmol Update Jan ;15(2):116-8.

Purpose: To assess the surgical outcome of modified trabeculotomy in primary congenital glaucoma patients at a tertiary care center in Larkana. Material and Methods: This was a prospective interventional case series study which was conducted from June 2014 to June 2016 at the department of pediatric ophthalmology, Chandka Medical College and Hospital, Larkana. Patients presenting with primary congenital glaucoma, from birth to 14 years of age were included in the study. Patients lost to follow up before six months postoperatively were excluded from the study. Slit lamp examination and examination under general anesthesia was done in every case. Preoperative and postoperative corneal clarity, corneal diameter, axial length and intra ocular pressure of patients were compared. Surgery was labeled successful if improvement was observed in any two of the four afore-mentioned variables. Patients were followed up at 1st day, two weeks, and one month postoperatively and monthly thereafter; maximum follow up period was 20 months. SPSS version 20 was used for data entry and analysis. Results: A total of 45 eyes of 29 patients of primary congenital glaucoma underwent modified trabeculotomy, out of which 15 (51.72%)were males and 14 (48.28%) were females. Mean age � standard deviation was 2.29 � 3.70 years and age range was 1 month to 12 years. Preoperative average corneal diameter was 13.90 � 1.18mm and postoperative average corneal diameter was 13.63 � 1.15 mm(P < 0.000454). Preoperative intra ocular pressure was 14.58 � 5.27 mm Hg and postoperative intra ocular pressure was 9.00 � 3.76 mm Hg (P <0.000001). Preoperative axial length was 23.45 � 3.29mm and postoperative axial length was 23.34 � 3.31 mm (P <0.0658). Corneas of 14 (31.11%) eyes became clear postoperatively. Follow up showed that 39 (86.67%) eyes fulfilled the criteria of successful surgery. Very few complications were encountered like hyphema and iridodialysis which were treated conservatively. Conclusion: Modified trabeculotomy has proved to be a safe and effective procedure for treating primary congenital glaucoma in our setting.

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