Hamed Esfandiari1, Syeda Sumara Taranum Basith2, Sudhi P Kurup2, Rebecca Mets-Halgrimson2, Kiana Hassanpour3, Hawke Yoon2, Janice Lasky Zeid2, Marilyn B Mets2, Angelo P Tanna4, Bahram Rahmani2. 1. Division of Ophthalmology, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, United States; Department of Ophthalmology, Northwestern University Feinberg School of Medicine, Chicago, United States. Electronic address: hmdesfandiary@gmail.com. 2. Division of Ophthalmology, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, United States; Department of Ophthalmology, Northwestern University Feinberg School of Medicine, Chicago, United States. 3. Ophthalmic Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran. 4. Department of Ophthalmology, Northwestern University Feinberg School of Medicine, Chicago, United States.
Abstract
PURPOSE: To analyze the long-term results of ab externo trabeculotomy with a Harms trabeculotome at a single, tertiary care pediatric hospital. METHODS: The medical records of pediatric patients operated on between September 2006 and June 2018 were reviewed retrospectively. Kaplan-Meier analysis was performed, with success defined as postoperative intraocular pressure (IOP) of ≤21 mm Hg, >20% reduction from preoperative IOP, and no need for further glaucoma surgery. Risk factors for failure were identified using Cox proportional hazards ratio. RESULTS: A total of 63 eyes of 40 patients were included. The cumulative probability of success rate was 83% at 3 months, 76% at 6, 73% at 12, 72% at 18, and 65% at final visit. Presentation within 3 months of life was associated with a less favorable outcome. Thirty-five eyes (56%) underwent repeat trabeculotomy to treat a different area of the trabecular meshwork because of inadequately controlled IOP after the first session. Of those who needed another session of trabeculotomy, the final success rate was 60.2%. IOP significantly decreased from 29.79 ± 7.67 mm Hg at baseline to 16.13 ± 3.41 mm Hg by final follow-up (P = 0.001). Patients were followed for an average of 85.74 ± 32.95 months. IOP and success rates remained stable 18 months after surgery. CONCLUSIONS: In our patient cohort, ab externo trabeculotomy was associated with good long-term results. More extensive trabeculotomy (ie, more than one procedure) was associated with better long-term success rates.
PURPOSE: To analyze the long-term results of ab externo trabeculotomy with a Harms trabeculotome at a single, tertiary care pediatric hospital. METHODS: The medical records of pediatric patients operated on between September 2006 and June 2018 were reviewed retrospectively. Kaplan-Meier analysis was performed, with success defined as postoperative intraocular pressure (IOP) of ≤21 mm Hg, >20% reduction from preoperative IOP, and no need for further glaucoma surgery. Risk factors for failure were identified using Cox proportional hazards ratio. RESULTS: A total of 63 eyes of 40 patients were included. The cumulative probability of success rate was 83% at 3 months, 76% at 6, 73% at 12, 72% at 18, and 65% at final visit. Presentation within 3 months of life was associated with a less favorable outcome. Thirty-five eyes (56%) underwent repeat trabeculotomy to treat a different area of the trabecular meshwork because of inadequately controlled IOP after the first session. Of those who needed another session of trabeculotomy, the final success rate was 60.2%. IOP significantly decreased from 29.79 ± 7.67 mm Hg at baseline to 16.13 ± 3.41 mm Hg by final follow-up (P = 0.001). Patients were followed for an average of 85.74 ± 32.95 months. IOP and success rates remained stable 18 months after surgery. CONCLUSIONS: In our patient cohort, ab externo trabeculotomy was associated with good long-term results. More extensive trabeculotomy (ie, more than one procedure) was associated with better long-term success rates.
Authors: Yifan Wu; Young Jin Seong; Kin Li; Dongwon Choi; Eunkyung Park; George H Daghlian; Eunson Jung; Khoa Bui; Luping Zhao; Shrimika Madhavan; Saren Daghlian; Patill Daghlian; Desmond Chin; Il-Taeg Cho; Alex K Wong; Martin Heur; Sandy Zhang-Nunes; James C Tan; Masatsugu Ema; Tina T Wong; Alex S Huang; Young-Kwon Hong Journal: JCI Insight Date: 2020-07-09