COPENHAGEN, Denmark — Complete 360° trabeculotomy with insertion of an illuminated microcatheter may be a good option in the treatment of pediatric glaucoma, according to a specialist.
At the European Glaucoma Society meeting, Thomas Klink, MD, PhD, reported using the technique in a 4-month-old infant with primary congenital glaucoma that was not responsive to medical treatment. The patient’s corneal diameters were 14 mm and 15 mm, and the axial lengths were 22.8 mm and 23.4 mm. Haab striae and corneal edema were present.
Klink performed an initial 3.5 × 3.5 mm scleral flap and a subsequent 1.2 mm flap to de-roof Schlemm’s canal. Viscoelastic was injected in the anterior chamber, and Schlemm’s canal was catheterized over 360° with the iTrack microcatheter (iScience Interventional). Iridectomy was performed at the end of the procedure, and sutures were applied to both flaps.
“The technique is not more difficult in children, as they have a wide open Schlemm’s canal, and the use of the illuminated catheter is very helpful,” he said.
At 2 weeks postop, IOP was 12 mm Hg, and no hyphema or hypotony were noted. Corneal edema had resolved in both eyes.
“We only have one case and a very short follow-up, but it would be interesting to collect data from other hospitals where this technique has been performed and perhaps set up a prospective study,” Klink said.
- Disclosure: Klink has no relevant financial disclosures.