title: Illuminated microcatheter circumferential trabeculotomy versus combined trabeculotomy-trabeculectomy for primary congenital glaucoma: a randomized controlled trial.
abstract: OBJECTIVE
  To compare outcomes of illuminated microcatheter-assisted circumferential trabeculotomy vs combined mitomycin C-augmented trabeculotomy-trabeculectomy for primary congenital glaucoma.
  
  
  METHODS
  Prospective, randomized trial.
  
  
  METHODS
  Of the 30 patients (60 eyes) analyzed with bilateral primary congenital glaucoma aged ≤2 years, 1 eye of each patient was randomized to: illuminated microcatheter-assisted trabeculotomy (Group I) or combined trabeculotomy with trabeculectomy augmented with mitomycin C (Group II). Primary outcome measure was intraocular pressure (IOP) reduction. Categorization into absolute success (IOP ≤15 mm Hg without medication) and qualified success (IOP ≤15 mm Hg with medication) was done. Secondary outcomes included change in corneal diameter and clarity, optic disc status, refraction, need for anti-glaucoma therapy, and occurrence of complications.
  
  
  RESULTS
  Mean age of patients was 6.63 ± 5.74 months. IOP fell by 49.3% (22.25 ± 10.88 to 11.56 ± 3.33 mm Hg) in Group I and 46.6% in Group II (21.73 ± 8.89 to 11.60 ± 3.03 mm Hg) (P < .001 in both). At 1 year, absolute success was achieved in 86.7% (26/30) and 90.0% (27/30) in Groups I and II, respectively (P >.99) and qualified success in 93.3% (28/30) in both groups (P = 1). There was significant improvement in corneal clarity (P < .001) and cup-to-disc ratio (P ≤ .01) in both groups at 1 year. Though incidence of hyphema was significantly more in Group I (P = .0001), no vision-threatening complications occurred in either group.
  
  
  CONCLUSIONS
  Illuminated microcatheter-assisted circumferential trabeculotomy achieved comparable surgical outcomes to mitomycin C-augmented combined trabeculotomy-trabeculectomy and may be recommended as the initial surgical procedure for primary congenital glaucoma.
authors.affiliation: Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Shreyas
authors.initials: S
authors.lastname: Temkar
authors.affiliation: Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Shikha
authors.initials: S
authors.lastname: Gupta
authors.affiliation: Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Ramanjit
authors.initials: R
authors.lastname: Sihota
authors.affiliation: Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Reetika
authors.initials: R
authors.lastname: Sharma
authors.affiliation: Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Dewang
authors.initials: D
authors.lastname: Angmo
authors.affiliation: Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Amar
authors.initials: A
authors.lastname: Pujari
authors.affiliation: Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India. Electronic address: tanujdada@gmail.com.
authors.forename: Tanuj
authors.initials: T
authors.lastname: Dada
mesh_terms: D057785:Catheters; D005260:Female; D006801:Humans; D006871:Hydrophthalmos / Q000601:surgery*; D007223:Infant; D007231:Infant, Newborn; D007429:Intraocular Pressure / Q000502:physiology; D008029:Lighting / Q000295:instrumentation*; D008297:Male; D016685:Mitomycin / Q000008:administration & dosage; D011446:Prospective Studies; D014065:Tonometry, Ocular; D014129:Trabecular Meshwork / Q000601:surgery*; D014130:Trabeculectomy / Q000295:instrumentation / Q000379:methods*
chemical_list: D016685:Mitomycin