Effect Of Combined Trabeculoctomy And Trabeculectomy On Congenital Glaucoma

Objective: To evaluate the long term clinical effects and safety of combined trabeculoctomy-trabeculectomy for congenital glaucoma.Methods: Twenty-one cases(thirty-three eyes) of congenital glaucoma, who performed combined trabeculoctomy-trabeculectomy plus mitomycin C as the initial surgical procedure, hospitalized between January2008to December2013were retrospectively analyzed.The intraocu1ar pressure, filter bleb, horizontal cornea diameter, C/D ratio and complication were observed and analyzed pre-and post-operation. All cases were followed up for1to77months. The mean follow-up was32.06±27.44months. Successful of operation were determined as：intraocular pressure≤21mmHg, with no antiglaucoma medication or only topical antiglaucoma drops; cornea resolved clearand; no adverse progression in horizontal cornea diameter and cup-disc ratio, or compared to pre-operation, horizontal cornea diameter and cup-disc ratio reduced.Results: The mean preoperative IOP was33.73±8.66mmHg, the mean postoperative IOP was16.78±6.78mmHg, the difference was significant(P<0.01). The success rate was81.82％. Compared to pre-operation, horizontal corneal diameter and C/D ratio of all cases was no longer extended. The complications were a small amount of hypema, of which was totally resolved in a few days without deal with and was little consequence to the final success rate. The complications such as vitreous loss, preterior or posterior synechia, endophthalmitis were not observed.Conclusions: Combined trabeculoctomy-trabeculectomy for congenital glaucoma is a safe and effective surgery.