Ophthalmology. Glaucoma · 2026
Two-Year Outcomes of Visco-Circumferential Suture Trabeculotomy vs. Rigid Probe Hemi-Trabeculotomy in Late-Onset Primary Congenital Glaucoma.
СтатьяНазвание и аннотация: Перевод в очереди
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Elwehidy Ahmed S, Elwehidy Mostafa A, Elzeini Rasha M, Elashry Mohammed, Allam Ghada H, Damlakhi Mostafa, Elhusseiny Abdelrahman M
Аннотация
OBJECTIVE: To compare the 2-year outcomes of visco-circumferential suture trabeculotomy (VCST) versus rigid probe hemi-trabeculotomy (RPHT) in late-onset primary congenital glaucoma (LPCG).
DESIGN: A retrospective cohort study.
SUBJECTS: Late-onset primary congenital glaucoma patients who underwent VCST or RPHT.
METHODS: A retrospective chart review was conducted on LPCG patients who underwent VCST or RPHT between January 2014 and December 2023 and had a minimum of 2 years of postoperative follow-up.
MAIN OUTCOME MEASURES: The primary outcome was surgical success, defined as complete success, intraocular pressure (IOP) ≤17 mmHg with ≥30% reduction from baseline, without antiglaucoma medications, and without anatomical evidence of glaucoma progression, or qualified success (meeting IOP criteria while requiring topical antiglaucoma medications [maximum of 3 agents]). The use of oral carbonic anhydrase inhibitors was considered a failure. Secondary outcomes included longitudinal changes in IOP, number of antiglaucoma medications, and incidence of complications.
RESULTS: A total of 79 eyes (79 patients) met the inclusion criteria (40 in the VCST group and 39 in the RPHT group). Baseline demographics were comparable between the 2 groups (mean age of 3.2 ± 0.3 years in the VCST vs. 3.1 ± 0.2 years in the RPHT, P = 0.42 years). At 24 months postoperatively, the overall success (complete and qualified) rate was significantly higher with VCST (95.00%) than with RPHT (84.66%; P = 0.04). Both procedures led to significant reductions in IOP from baseline, but eyes in the VCST group consistently exhibited lower mean IOP over the 24-month follow-up, with differences reaching statistical significance from the 18th month onward following Bonferroni correction (e.g., 13.7 ± 2.7 mmHg vs. 15.8 ± 3.6 mmHg at 18 months; P = 0.004). Transient hyphema was the most common complication that occurred in 66 of 79 eyes (83.5%) overall, more frequent in the VCST than in the RPHT group (relative risk: 1.24; 95% confidence interval: 1.01-1.53; P = 0.04).
CONCLUSIONS: In this cohort, VCST achieved higher 2-year surgical success rates and more sustained IOP reduction compared with RPHT.
FINANCIAL DISCLOSURE(S): The authors have no proprietary or commercial interest in any materials discussed in this article.
DESIGN: A retrospective cohort study.
SUBJECTS: Late-onset primary congenital glaucoma patients who underwent VCST or RPHT.
METHODS: A retrospective chart review was conducted on LPCG patients who underwent VCST or RPHT between January 2014 and December 2023 and had a minimum of 2 years of postoperative follow-up.
MAIN OUTCOME MEASURES: The primary outcome was surgical success, defined as complete success, intraocular pressure (IOP) ≤17 mmHg with ≥30% reduction from baseline, without antiglaucoma medications, and without anatomical evidence of glaucoma progression, or qualified success (meeting IOP criteria while requiring topical antiglaucoma medications [maximum of 3 agents]). The use of oral carbonic anhydrase inhibitors was considered a failure. Secondary outcomes included longitudinal changes in IOP, number of antiglaucoma medications, and incidence of complications.
RESULTS: A total of 79 eyes (79 patients) met the inclusion criteria (40 in the VCST group and 39 in the RPHT group). Baseline demographics were comparable between the 2 groups (mean age of 3.2 ± 0.3 years in the VCST vs. 3.1 ± 0.2 years in the RPHT, P = 0.42 years). At 24 months postoperatively, the overall success (complete and qualified) rate was significantly higher with VCST (95.00%) than with RPHT (84.66%; P = 0.04). Both procedures led to significant reductions in IOP from baseline, but eyes in the VCST group consistently exhibited lower mean IOP over the 24-month follow-up, with differences reaching statistical significance from the 18th month onward following Bonferroni correction (e.g., 13.7 ± 2.7 mmHg vs. 15.8 ± 3.6 mmHg at 18 months; P = 0.004). Transient hyphema was the most common complication that occurred in 66 of 79 eyes (83.5%) overall, more frequent in the VCST than in the RPHT group (relative risk: 1.24; 95% confidence interval: 1.01-1.53; P = 0.04).
CONCLUSIONS: In this cohort, VCST achieved higher 2-year surgical success rates and more sustained IOP reduction compared with RPHT.
FINANCIAL DISCLOSURE(S): The authors have no proprietary or commercial interest in any materials discussed in this article.