Original Article 

Trabeculectomy Versus Combined Trabeculotomy-Trabeculectomy in Pediatric Glaucoma

Scott D. Lawrence, MD; Peter A. Netland, MD, PhD

  • Journal of Pediatric Ophthalmology and Strabismus
  • November/December 2012 - Volume 49 · Issue 6: 359-365
  • DOI: 10.3928/01913913-20120710-06

Abstract

Purpose:

To compare outcomes between trabeculectomy and combined trabeculotomy-trabeculectomy in children with glaucoma.

Methods:

This was a retrospective, comparative study of 40 eyes in 33 patients with pediatric glaucoma: 17 eyes treated with trabeculectomy and 23 eyes treated with combined trabeculotomy-trabeculectomy. Both groups were treated with intraoperative mitomycin C. Success was defined as intraocular pressure (IOP) of 21 mm Hg or less and greater than 5 mm Hg with no additional glaucoma surgery.

Results:

Mean follow-up was 38.3 months. There was no significant difference in mean IOP lowering between groups during the follow-up period. Log-rank survival analysis showed a significantly higher success rate after combined surgery compared with trabeculectomy (P = .027). Treatment failures occurred in 5 patients with trabeculectomy and in 2 patients undergoing combined trabeculotomy-trabeculectomy. Failures resulted from increased IOP (n = 3) or hypotony (n = 4). There were no significant differences in complications observed after surgery in both groups.

Conclusion:

Trabeculectomy and combined trabeculotomy-trabeculectomy with mitomycin C were equally effective at lowering average IOP in children. Combined trabeculotomy-trabeculectomy was associated with greater long-term success.

From the Department of Ophthalmology (SDL), University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; and the Department of Ophthalmology (PAN), University of Virginia School of Medicine, Charlotteville, Virginia.

The authors have no financial or proprietary interest in the materials presented herein.

Address correspondence to Peter A. Netland, MD, PhD, Department of Ophthalmology, University of Virginia School of Medicine, 1300 Jefferson Park Avenue, P. O. Box 800715, Charlotteville, VA 22908-0715. E-mail: pnetland@virginia.edu

Received: January 08, 2012
Accepted: May 30, 2012
Posted Online: July 17, 2012

10.3928/01913913-20120710-06

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