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Cristiana Soares Soares Ronconi, Flavio Siqueira Santos Lopes, Flavio E Hirai, Marcia Keiko U Tabuse, Ivan Maynart Tavares, Christiane Rolim de Moura; SURGICAL RESULTS OF TRABECULOTOMY AND GONIOTOMY FOR PRIMARY CONGENITAL GLAUCOMA: DATA AFTER NEW AMBULATORY SURGICAL CENTER FACILITIES. Invest. Ophthalmol. Vis. Sci. 2014;55(13):4499.
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To evaluate the results of trabeculotomy and goniotomy in primary congenital glaucoma.
Charts of patients submitted to trabeculotomy or goniotomy at the Department of Ophthalmology, Federal University of São Paulo, between January 2011 and January 2013, were reviewed retrospectively. Inclusion criteria were: diagnosis of PCG, surgical indication for trabeculotomy or goniotomy and minimum postoperative follow up of 8 months. Exclusion criteria were: presence of ocular or systemic disease and/or other causes that could cause secondary glaucoma. Patients with previous ocular surgery as well those whose angular surgery was converted to filtering surgery intraoperatively (trabeculotomy-trabeculectomy) were also excluded. Data on corneal diameter, biometry, fundoscopy and measurement of the intraocular pressure were analyzed pre and postoperatively. Failure criterion was the need of filtering surgery.
Among the patients who were submitted to surgery in the determined period, 21 eyes (12 patients) met the inclusion criteria. Eleven of these patients were male, and in only four of them the disease was unilateral. Of these selected eyes, 17 had trabeculotomy as the first intervention, while four had goniotomy. Five (25%) patients needed an extra angular surgery (four trabeculotomies and one goniotomy) and, at the end of follow up (mean, 17.62 months), five (25%) patients had been submitted to filtrating surgery (mitomycin-C augmented trabeculectomy).
Although inferior to the ones described in developed countries, the present success rate is higher than the one described 10 years ago. This improvement is credited to the implementation of new ambulatory surgical center facilities, in which patients can be submitted more frequently to under anesthesia exams, and promptly retreated when necessary. However, the delayed diagnosis and difficulty access to the public health system are still limitations for achieving higher surgical success rates.
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