LAUSR

PURPOSE To compare the surgical outcomes of viscocircumferential-suture-trabeculotomy(VCST) to rigid probe double-entry viscotrabeculotomy(DEVT) and rigid probe single-entry viscotrabeculotomy (SEVT) in infants with neonatal onset primary congenital glaucoma(PCG). DESIGN Retrospective chart review. PATIENTS AND METHODS Retrospective chart review of 64 eyes of 64 infants with neonatal-onset PCG referred to Mansoura Ophthalmic Center in Mansoura, Egypt between February 2008 and November 2018. Study groups included VCST, DEVT and SEVT and follow up covered 4 postoperative years. Complete (qualified) success was defined as an IOP≤18 mmHg and with 35% IOP reduction from baseline without (with) IOP-lowering medications or further surgical interventions, and without any sign of progression in corneal diameter, axial length, or optic disc cupping and without visual devastating complications. RESULTS The mean±standard deviation age at presentation and at surgery of the study children was 3.63±1.74 days and 55.23±1.60 days respectively. The mean±standard deviation IOP and C/D ratio of all study eyes at presentation and at final follow up were 34.91±0.82 mmHg and 0.70±0.09 and 17.04±0.74 mmHg and 0.63±0.08 respectively. Complete success was achieved in 54.5%, 43.5% and 31.6% in the VCST, DEVT and SEVT groups respectively. A self limited hyphema was the commonest complication in all groups. CONCLUSIONS Angle procedures are safe and marginally effective for the surgical treatment of neonatal onset PCG, bringing IOP under control for at least 4 years of follow up. Circumferential trabeculotomy as a first-line treatment has more favorable outcomes than rigid probe SEVT. Rigid probe viscotrabeculotomy offers an alternative for non-completed circumferential procedure.