Goniotomy vs trabeculotomy.

Goniotomy is a safe effective procedure in isolated trabeculodysgenesis occurring in children under the age of two years, and is preferred by the authors in all such cases when visibility allows. It may also be effective for varying periods of time in Sturge-Weber syndrome, Aniridia, Axenfeld's syndrome, and Lowe's syndrome when these occur in infancy. Trabeculotomy is generally preferred in children with trabeculodysgenesis over the age of three years, in situations where corneal clouding prevents adequate visualization of the trabecular meshwork, and in patients with aniridia. In the latter group, although goniotomy can be effective, its success rate is low. The absence of iris covering the lens does increase the risk of lenticular injury and, therefore, trabeculotomy is usually chosen.