PMID- 28860043
OWN - NLM
STAT- MEDLINE
DCOM- 20171102
LR  - 20220317
IS  - 1879-1891 (Electronic)
IS  - 0002-9394 (Linking)
VI  - 183
DP  - 2017 Nov
TI  - Circumferential Trabeculotomy Versus Conventional Angle Surgery: Comparing 
      Long-term Surgical Success and Clinical Outcomes in Children With Primary 
      Congenital Glaucoma.
PG  - 17-24
LID - S0002-9394(17)30342-2 [pii]
LID - 10.1016/j.ajo.2017.08.008 [doi]
AB  - PURPOSE: This study compares the long-term efficacy of circumferential 
      trabeculotomy to that of conventional angle surgeries in primary congenital 
      glaucoma (PCG), as judged by glaucoma and visual outcomes. DESIGN: Retrospective 
      observational case series. METHODS: Setting: Emory Eye Center, Atlanta, Georgia. 
      STUDY POPULATION: This was a single-institution retrospective study involving 
      children with PCG who underwent circumferential trabeculotomy, standard 
      trabeculotomy, or goniotomy with >/=2-year follow-up. MAIN OUTCOME MEASURES: 
      Postoperative success (intraocular pressure [IOP] < 22 mm Hg +/- glaucoma 
      medications, without glaucoma progression/additional IOP-lowering surgery), 
      Snellen-equivalent visual acuity (VA), and IOP at last follow-up. Kaplan-Meier 
      method estimated the probability of glaucoma control vs time postoperatively, and 
      values were compared between angle surgery cohorts using Wilcoxon signed rank 
      tests, Mann-Whitney U tests, and Fisher exact tests. RESULTS: Included were 58 
      eyes (33 children) after circumferential trabeculotomy and 42 eyes (27 children) 
      after standard trabeculotomy/goniotomy, with mean follow-up of 7.2 +/- 4.0 and 8.2 
      +/- 4.5 years, respectively. Postoperative success at last follow-up in the 
      circumferential vs conventional cohorts was 81% (47 of 58 eyes) vs 31% (13 of 42 
      eyes) (P < .0001). At last follow-up, the circumferential cohort had better 
      median VA than the conventional cohort (20/30 (interquartile range [IQR] 20/25 to 
      20/70) vs 20/70 (IQR 20/40 to 20/200), P = .009), required fewer glaucoma 
      medications (0.55 +/- 1.2 vs 1.61 +/- 1.51, P < .0001), had lower IOP in first 
      operated eye (15.2 +/- 3.6 vs 18.2 +/- 7.0, P = .048), and had comparable incidence 
      of devastating complications (P = .065). CONCLUSIONS: In this retrospective 
      study, circumferential trabeculotomy afforded better long-term success and visual 
      outcomes than conventional angle surgery for children with PCG.
CI  - Copyright (c) 2017 Elsevier Inc. All rights reserved.
FAU - Neustein, Rebecca F
AU  - Neustein RF
AD  - Department of Ophthalmology, Emory University School of Medicine, Atlanta, 
      Georgia.
FAU - Beck, Allen D
AU  - Beck AD
AD  - Department of Ophthalmology, Emory University School of Medicine, Atlanta, 
      Georgia. Electronic address: abeck@emory.edu.
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Observational Study
DEP - 20170830
PL  - United States
TA  - Am J Ophthalmol
JT  - American journal of ophthalmology
JID - 0370500
SB  - IM
MH  - Female
MH  - Filtering Surgery/methods
MH  - Follow-Up Studies
MH  - Glaucoma/congenital/physiopathology/*surgery
MH  - Gonioscopy
MH  - Humans
MH  - Infant
MH  - *Intraocular Pressure
MH  - Male
MH  - Retrospective Studies
MH  - Time Factors
MH  - Trabeculectomy/*methods
MH  - Treatment Outcome
MH  - *Visual Acuity
EDAT- 2017/09/02 06:00
MHDA- 2017/11/03 06:00
CRDT- 2017/09/02 06:00
PHST- 2017/05/11 00:00 [received]
PHST- 2017/08/14 00:00 [revised]
PHST- 2017/08/17 00:00 [accepted]
PHST- 2017/09/02 06:00 [pubmed]
PHST- 2017/11/03 06:00 [medline]
PHST- 2017/09/02 06:00 [entrez]
AID - S0002-9394(17)30342-2 [pii]
AID - 10.1016/j.ajo.2017.08.008 [doi]
PST - ppublish
SO  - Am J Ophthalmol. 2017 Nov;183:17-24. doi: 10.1016/j.ajo.2017.08.008. Epub 2017 
      Aug 30.