Shabeer Ahmed Bhutto, Syed Shujaat Ali Shah, Syed Imtiaz Ali Shah.
Efficacy of Combined Modified Trabeculotomy & Trabeculectomy in Primary Congenital Glaucoma.
Ophthalmol Update Jan ;15(3):248-50.

Purpose: To assess the efficacy of combined modified trabeculotomy and trabeculectomy in primary congenital glaucoma at a tertiary care center in Larkana. Material and Methods: This was a prospective interventional case series study which was conducted from August 2014 to August 2016 at the department of pediatric ophthalmology, Chandka Medical College and Hospital, Larkana, Pakistan. Patients attending the OPD from birth to 14 years of age with primary congenital glaucoma were included in the study. Patients lost before six months to follow up postoperatively were excluded from the study. Slit lamp examination under general anesthesia was performed preoperatively in every case, corneal clarity, average corneal diameter, axial length and intra ocular pressure were noted and compared with postoperative values. Improvement observed in any two of the four abovementioned variables was considered as successful surgery. SPSS version 20 was used for data entry and analysis. Results: Combined modified trabeculotomy and trabeculectomy was performed in 22 eyes of 17 patients with primary congenital glaucoma, out of which 08 (47.06%) were males and 09 (52.94%) were females. Mean age � standard deviation was 3.37 � 4.40 years and age range was 1 month to 12 years. Preoperative average corneal diameter was 14.47 � 1.10 mm and postoperative average corneal diameter was 14.15 � 1.13 mm (P < 0.015). Preoperative intra ocular pressure was 15.05 � 6.75 mm Hg and postoperative intra ocular pressure was 9.59 � 3.98 mm Hg (P <0.000026). Preoperative axial length was 25.30 � 3.59 mm and postoperative axial length was 25.02 � 3.77 mm (P <0.011). Criteria for successful surgery were fulfilled by 20(90.91%) eyes and corneas of 12 (54.54%) eyes became clear postoperatively. Conclusion: According to our study combined modified trabeculotomy and trabeculectomy procedure is a very efficient and safe procedure for primary congenital glaucoma with a high success rate. Keywords: Primary congenital glaucoma, Modified Trabeculotomy, Trabeculectomy, Intraocular pressure.

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