Abstract
In this section, we address the role and execution of ab externo trabeculotomy in pediatric glaucoma. We provide an in-depth comparison of different techniques with detailed descriptions of traditional trabeculotomy with metal trabeculotome, ab externo circumferential trabeculotomy with either an illuminated microcatheter or blunted suture filament, and trabeculotomy combined with filtration surgery such as combined trabeculectomy-trabeculotomy and filtering trabeculotomy. For each there are sections on preoperative preparation, execution of the relevant surgery (with tips for problem-solving and avoiding complications), and postoperative management of the child. In addition, there is a comprehensive review of the literature to date, describing the evolution of trabeculotomy in the management of the pediatric glaucomas, and the evidence base for variations in technique, surgical preferences, and outcomes.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Barkan O. Operation for congenital glaucoma. Am J Ophthalmol. 1942;25(5):552–68.
SD MP Jr, McFarland D. External trabeculectomy for developmental glaucoma. Ophthalmology. 1980;87(4):302–5.
Dietlein TS, Jacobi PC, Krieglstein GK. Prognosis of primary ab externo surgery for primary congenital glaucoma. Br J Ophthalmol. 1999;83(3):317–22.
Akimoto M, Tanihara H, Negi A, Nagata M. Surgical results of trabeculectomy ab externo for developmental glaucoma. Arch Ophthalmol. 1994;112(12):1540–4.
Luntz MH, Livingston DG. Trabeculotomy ab externo and trabeculectomy in congenital and adult-onset glaucoma. Am J Ophthalmol. 1977;83(2):174–9.
Beck AD, Lynch MG. 360 degrees trabeculotomy for primary congenital glaucoma. Arch Ophthalmol. 1995;113(9):1200–2.
Sarkisian SR Jr. An illuminated microcatheter for 360-degree trabeculotomy [corrected] in congenital glaucoma: a retrospective case series. J AAPOS. 2010;14(5):412–6.
Grover DS, Godfrey DG, Smith O, Feuer WJ, Montes de Oca I, Fellman RL. Gonioscopy-assisted transluminal trabeculotomy, ab interno trabeculotomy: technique report and preliminary results. Ophthalmology. 2014;121(4):855–61.
Maul E, Strozzi L, Munoz C, Reyes C. The outflow pathway in congenital glaucoma. Am J Ophthalmol. 1980;89(5):667–73.
Sampaolesi R. Congenital glaucoma: long-term results of surgery. Dev Ophthalmol. 1987;14:166–76.
Mandal AK, Naduvilath TJ, Jayagandan A. Surgical results of combined trabeculotomy-trabeculectomy for developmental glaucoma. Ophthalmology. 1998;105(6):974–82.
Biedner BZ, Rothkoff L. Combined trabeculotomy-trabeculectomy compared with primary trabeculotomy for congenital glaucoma. J Pediatr Ophthalmol Strabismus. 1998;35(1):49–50.
Mandal AK, Prasad K, Naduvilath TJ. Surgical results and complications of mitomycin C augmented trabeculectomy in refractory developmental glaucoma. Ophthalmic Surg Lasers. 1999;30(6):473–80.
Mullaney PB, Selleck C, Al-Awad A. Combined trabeculotomy and trabeculectomy as an initial procedure in uncomplicated congenital glaucoma. Arch Ophthalmol. 1999;117(4):457–560.
al-Hazmi A, Awad A, Zwaan J. Correlation between surgical success rate and severity of congenital glaucoma. Br J Ophthalmol. 2005;89(4):449–53.
Zhang X, Du S, Fan Q, Peng S, Yu M, Ge J. Long-term surgical outcomes of primary congenital glaucoma in China. Clinics (Sao Paulo, Brazil). 2009;64(6):543–51.
Jalil A, Au L, Khan I, Ashworth J, Lloyd IC, Biswas S. Combined trabeculotomy–trabeculectomy augmented with 5-fluorouracil in paediatric glaucoma. Clin Exp Ophthalmol. 2011;39(3):207–14.
Dubey S, Agrawal A, Chauhan L, Mukherjee S, Douglas G. Combined trabeculotomy-trabeculectomy with antimetabolite and releasable suture: outcome with primary congenital glaucoma in a north Indian population. Nepal J Ophthalmol. 2015;7(1):16–25.
Harms H, Dannheim R. Epicritical consideration of 300 cases of trabeculotomy 'ab externo'. Trans Ophthalmol Soc U K. 1969;89:491–9.
Elder MJ. Combined trabeculotomy-trabeculectomy compared with primary trabeculectomy for congenital glaucoma. Br J Ophthalmol. 1994;78(10):745–8.
Mandal AK, Matalia JH, Nutheti R, Krishnaiah S. Combined trabeculotomy and trabeculectomy in advanced primary developmental glaucoma with corneal diameter of 14 mm or more. Eye (Lond). 2006;20(2):135–43.
al-Hazmi A, Zwaan J, Awad A. Effectiveness and complications of mitomycin C use during pediatric glaucoma surgery. Ophthalmology. 1998;105(10):1915–20.
Jalil A, Au L, Khan I, Ashworth J, Lloyd IC, Biswas S. Combined trabeculotomy-trabeculectomy augmented with 5-fluorouracil in paediatric glaucoma. Clin Exp Ophthalmol. 2011;39(3):207–14.
Matlach J, Hipp M, Wagner M, Heuschmann PU, Klink T, Grehn F. A comparative study of a modified filtering trabeculotomy and conventional trabeculectomy. Clin Ophthalmol. 2015;9:483–92.
ElSheikha OZ, Abdelhakim MA, Elhilali HM, Kassem RR. Is viscotrabeculotomy superior to conventional trabeculotomy in the management of Egyptian infants with congenital glaucoma? Acta Ophthalmol. 2015;93(5):e366–71.
Tamcelik N, Ozkiris A, Sarici AM. Long-term results of combined viscotrabeculotomy-trabeculectomy in refractory developmental glaucoma. Eye (Lond). 2010;24(4):613–8.
Mandal AK. Primary combined trabeculotomy-trabeculectomy for early-onset glaucoma in Sturge-Weber syndrome. Ophthalmology. 1999;106(8):1621–7.
Beck AD, Lynch MJ, Crandall J, Mobin-Uddin O. Surgical outcomes with 360-degree suture trabeculotomy in poor-prognosis primary congenital glaucoma and glaucoma associated with congenital anomalies or cataract surgery. J AAPOS. 2011;15:54–8.
Shi Y, Wang H, Yin J, Zhang X, Li M, Xin C, et al. Outcomes of microcatheter-assisted trabeculotomy following failed angle surgeries in primary congenital glaucoma. Eye (Lond). 2017;31(1):132–9.
Alward WL. Chapter 11, Primary congenital glaucoma. Version 1.0. 28 Sep 2015. Iowa Glaucoma Curriculum. http://curriculum.iowaglaucoma.org/chapter/11. Accessed 12 Mar 2018.
Lim ME, Neely DE, Wang J. Comparison of 360 degree with traditional trabeculotomy in pediatric glaucoma. J AAPOS. 2015;19(2):145–9.
Gloor BR. Gefahren der 360 degrees-Fadentrabekulotomie [Risks of 360 degree suture trabeculotomy]. Ophthalmologe. 1998;95(2):100–3. [Article in German]
Neely DE. False passage: a complication of 360 degrees suture trabeculotomy. J AAPOS. 2005;9(4):396–7.
Wise J, Toygar O, Correa ZM, Miller DM, Sisk RA. Subretinal cannulation as a complication of suture trabeculotomy surgery in a pediatric patient. Retin Cases Brief Rep. 2017;11(1):79–82.
Luntz MH. Congenital, infantile, and juvenile glaucoma. Ophthalmology. 1979;86(5):793–802.
Quigley HA. Childhood glaucoma: results with trabeculotomy and study of reversible cupping. Ophthalmology. 1982;89(3):219–26.
Debnath SC, Teichmann KD, Salamah K. Trabeculectomy versus trabeculotomy in congenital glaucoma. Br J Ophthalmol. 1989;73:608–11.
Elder MJ. Congenital glaucoma in the West Bank and Gaza Strip. Br J Ophthalmol. 1993;77(7):413–6.
Meyer G, Schwenn O, Pfeiffer N, Grehn F. Trabeculotomy in congenital glaucoma. Graefes Arch Clin Exp Ophthalmol. 2000;238(3):207–13.
Tamcelik N, Ozkiris A. Long-term results of viscotrabeculotomy in congenital glaucoma: comparison to classical trabeculotomy. Br J Ophthalmol. 2008;92:36–9.
Yalvac IS, Satana B, Suveren A, Eksioglu U, Duman S. Success of trabeculotomy in patients with congenital glaucoma operated on within 3 months of birth. Eye (Lond). 2007;21(4):459–64.
Papadopoulos M, Edmunds B, Chiang M, Mandal A, Grajewski AL, Khaw PT. Glaucoma surgery in children. In: Weinreb RN, Grajewski A, Papadopoulos M, Grigg J, Freedman S, editors. Childhood glaucoma, WGA consensus series 9. Amsterdam: Kugler Publications; 2013. p. 95–134.
Shi Y, Wang H, Yin J, Li M, Zhang X, Xin C, et al. Microcatheter-assisted trabeculotomy versus rigid probe trabeculotomy in childhood glaucoma. Br J Ophthalmol. 2016;100(9):1257–62.
Neustein RF, Beck AD. Circumferential trabeculotomy versus conventional angle surgery: comparing long-term surgical success and clinical outcomes in children with primary congenital glaucoma. Am J Ophthalmol. 2017;183:17–24.
Girkin CA, Rhodes L, McGwin G. Goniotomy versus circumferential trabeculotomy with an illuminated microcatheter in congenital glaucoma. J AAPOS. 2012;16(5):424–7.
El Sayed Y, Gawdat G. Two-year results of microcatheter-assisted trabeculotomy in paediatric glaucoma: a randomized controlled study. Acta Ophthalmol. 2017;95(8):e713–9.
Shakrawal J, Bali S, Sidhu T, Verma S, Sihota R, Dada T. Randomized trial on illuminated-microcatheter circumferential trabeculotomy versus conventional trabeculotomy in congenital glaucoma. Am J Ophthalmol. 2017;180:158–64.
Temkar S, Gupta S, Sihota R. Illuminated microcatheter circumferential trabeculotomy versus combined trabeculotomy-trabeculectomy for primary congenital glaucoma: a randomized controlled trial. Am J Ophthalmol. 2015;159(3):490–7.
Dao JB, Sarkisian SR Jr, Freedman SF. Illuminated microcatheter-facilitated 360-degree trabeculotomy for refractory aphakic and juvenile open-angle glaucoma. J Glaucoma. 2014;23(7):449–54.
Lim ME, Dao JB, Freedman SF. 360-Degree trabeculotomy for medically refractory glaucoma following cataract surgery and juvenile open-angle glaucoma. Am J Ophthalmol. 2017;175:1–7.
Konstas AG, Jay JL. Modification of trabeculectomy to avoid postoperative hyphaema. The 'guarded anterior fistula' operation. Br J Ophthalmol. 1992;76(6):353–7.
Bayoumi NH. Deep sclerectomy in pediatric glaucoma filtering surgery. Eye (Lond). 2012;26(12):1548–53.
Khan AO. Trabeculotomy versus trabeculotomy-trabeculectomy for congenital glaucoma. Br J Ophthalmol. 2006;90(1):125.
Chang TC, Cavuoto KM. Surgical management in primary congenital glaucoma: four debates. J Ophthalmol. 2013;2013:612708.
Mandal AK, Gothwal VK, Nutheti R. Surgical outcome of primary developmental glaucoma: a single surgeon's long-term experience from a tertiary eye care centre in India. Eye (Lond). 2007;21(6):764–74.
Essuman VA, Braimah IZ, Ndanu TA, Ntim-Amponsah CT. Combined trabeculotomy and trabeculectomy: outcome for primary congenital glaucoma in a West Africa population. Eye (Lond). 2011;25(1):77–83.
Campos-Mollo E, Moral-Cazalla R, Belmonte-Martinez J. Combined trabeculotomy-trabeculectomy as the initial surgical procedure of primary developmental glaucoma. Arch Soc Esp Oftalmol. 2008;83(8):479–85. [Article in Spanish]
Khalil DH, Abdelhakim MA. Primary trabeculotomy compared to combined trabeculectomy-trabeculotomy in congenital glaucoma: 3-year study. Acta Ophthalmol. 2016;94(7):e550–e4.
Alsheikheh A, Klink J, Klink T, Steffen H, Grehn F. Long-term results of surgery in childhood glaucoma. Graefes Arch Clin Exp Ophthalmol. 2007;245(2):195–203.
Ghate D, Wang X. Surgical interventions for primary congenital glaucoma. Cochrane Database Syst Rev. 2015;1:CD008213.
Mandal AK, Walton DS, John T, Jayagandan A. Mitomycin C-augmented trabeculectomy in refractory congenital glaucoma. Ophthalmology. 1997;104(6):996–1003.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Electronic Supplementary Material
Conventional trabeculotomy with metal trabeculotome (Courtesy of Professor Nader Bayoumi, Alexandria University, Egypt) (MP4 10860 kb)
Circumferential trabeculotomy, ab externo, with illuminated microcatheter (Courtesy of Beth Edmunds, MBChB, FRCOphth, MD) (MP4 80191 kb)
Circumferential trabeculotomy, ab externo, with blunted suture (Courtesy of Allen D. Beck, MD) (MPG 95372 kb)
Filtering trabeculotomy (Courtesy of Franz Grehn, MD, PhD) (MP4 153032 kb)
Combined trabeculectomy-trabeculotomy (CTT) (Courtesy of Professor Nader Bayoumi, Alexandria University, Egypt) (MP4 178733 kb)
Rights and permissions
Copyright information
© 2018 Springer Nature Switzerland AG
About this chapter
Cite this chapter
Edmunds, B., Beck, A.D., Hoffmann, E., Grehn, F. (2018). Angle Surgery: Trabeculotomy. In: Grajewski, A., Bitrian, E., Papadopoulos, M., Freedman, S. (eds) Surgical Management of Childhood Glaucoma. Springer, Cham. https://doi.org/10.1007/978-3-319-54003-0_5
Download citation
DOI: https://doi.org/10.1007/978-3-319-54003-0_5
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-319-54002-3
Online ISBN: 978-3-319-54003-0
eBook Packages: MedicineMedicine (R0)