Trabeculectomy versus combined trabeculotomy-trabeculectomy in pediatric glaucoma.
OBJECTIVE
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.


CONCLUSIONS
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.
Scott D
SD
Lawrence
Peter A
PA
Netland
D000293:Adolescent; D000477:Alkylating Agents / Q000008:administration & dosage; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D005901:Glaucoma / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D007223:Infant; D007429:Intraocular Pressure / Q000502:physiology; D008297:Male; D016685:Mitomycin / Q000008:administration & dosage; D012189:Retrospective Studies; D014065:Tonometry, Ocular; D014129:Trabecular Meshwork / Q000601:surgery*; D014130:Trabeculectomy / Q000379:methods*; D016896:Treatment Outcome
D000477:Alkylating Agents; D016685:Mitomycin