Deep sclerectomy vs combined trabeculectomy trabeculotomy in congenital glaucoma: a randomized clinical trial

Session Details

Session Title: Glaucoma I

Session Date/Time: Monday 07/09/2015 | 08:00-10:30

Paper Time: 08:56

Venue: Room 10

First Author: : S.Al Obeidan SAUDI ARABIA

Co Author(s): :    A. Mousa   E. Osman                 

Abstract Details

Purpose:

There is a debate among the scientific community on the best glaucoma surgical procedure to be used in congential glaucoma. Thus, there is a need to compare the efficacy and safety of Deep sclerectomy to combined trabeculectomy trabeculotomy in congenital glaucoma in a randomized controlled trial study design.

Setting:

A randomized clinical trial conducted in King Abdul Aziz University Hospital, Riyadh, Saudi Arabia

Methods:

A consecutive number of newborn children with congenital glaucoma were recruited in this study. Surgical procedure was randomly allocated to the first operated eye of each child. Pre and post intervention glaucoma indices were assessed including; intraocular pressure, cup/disc ratio, corneal diameter, corneal thickness, number of anti-glaucoma medications, and degree corneal haze. Complete success was identified as achieving post operative IOP <21 without any anti-glaucoma medication.

Results:

Seventy eyes of 35 patients were recruited in this study. Intraocular pressure, number of medications and corneal haze has significantly reduced in each arm. Reduction in IOP, number of medications, CDR, and degree of haze have insignificantly differed across both groups (p = 0.723, 0.729, 0.998, and 0.692 respectively). The overall rate of complications (52.6%) was significantly higher in the combined arm than in the deep sclerectomy arm (5.7%; p < 0.001). The complete success rate was 68.6% in deep sclerectomy and 57.1% in the combined arm where such difference didn't reach the statistical significance level.

Conclusions:

Although the combined trabeculectomy trabeculotomy procedure has excellent impact on IOP reduction, it yields a number of serious sight threatening post operative complications. Deep sclerectomy procedure may give higher reduction in IOP; however, such reduction insignificantly differs from the combined procedure. Nevertheless, deep sclerectomy is much safer in terms of its lower rate of visually threatening complications.

Financial Interest:

NONE