Sarfraz Hussain Syed.
Success of Trabeculotomy Procedure in Primary Pediatric Glaucoma by Measuring the Change in Axial Length After Procedure.
Annals Punjab Med Coll Jan ;9(1):31-40.

Objective: To study the success of Trabeculotomy procedure in Primary Pediatric glaucoma by measuring the change in axial length after procedure.  Study Design: This was prospective, non-comparative, interventional study. Study Period: One year from July, 2011 to June, 2012. Material and Methods: This was carried out in the department of Pediatric Ophthalmology at College of Ophthalmology and Allied Vision Sciences (COAVS), King Edward Medical University (KEMU), Mayo Hospital, Lahore, Pakistan. Thirty (30) eyes of patients, from birth to 8 years of age with Primary pediatric glaucoma (PPG) were included in the study. The patients were selected after a suspicion of pediatric glaucoma from history and clinical examination. The patients were admitted from pediatric eye OPD of Mayo Hospital Lahore. Examination under general anesthesia was performed and axial length measurements were recorded. Those diagnosed as primary pediatric glaucoma underwent trabeculotomy. Post-operative serial examinations within 1st, 3rd and 6th month were performed with recording of axial length measurements. Results: Thirty  eyes of 16 patients of primary pediatric glaucoma were included in this study. 9 patients (56%) were males and 7 patients (44%) were females. 2 (12.5%) patients had unilateral disease and 14 (87.5%) patients had bilateral disease.  The age of patients ranged from 2 months to 96 months with a mean of 26.77 months. 16 eyes (53%) were involved in patients  below 12 months of age, 5 eyes (17%) were involved in patients of 13 to 36 months. 9 eyes (30%) were involved in the patients of 37 months and above age. All patients have longer axial length than normal age matched children with higher growth rate. All underwent trabeculotomy.  There was an increase in axial length in all eyes after trabeculotomy but the change in axial length was much slower than preoperative growth rate in age matched children. The change in axial length was stabilized and normalized in these cases after 6 months of surgery. Conclusion: The success of trabeculotomy procedure can be assessed by axial length measurements before and after the procedure.  Ttrabeculotomy has proven to be a safe and effective procedure for control of primary pediatric glaucoma.

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