Background: The aim of the current meta-analysis was to compare the efficacy of microcatheter-assisted circumferential trabeculotomy (Group 1) with that of conventional trabeculotomy (Group 2) for the treatment of childhood glaucoma.
Methods: Published studies were systematically searched via the Web of Science, PubMed, Embase, and Cochrane Library databases. Odds ratios and 95% confidence intervals were calculated for dichotomous variables. Mean ± the standard deviation, mean difference, and 95% confidence intervals were calculated for continuous variables. Heterogeneity was assessed. Random effects modeling and RevMan version 5.30 were used to analyze the data.
Results: Five eligible studies were included in the meta-analysis. Mean postoperative intraocular pressures were significantly lower in Group 1 than in Group 2 at 3 months ( = 0.03), 6 months ( = 0.03), and 12 months ( = 0.007) postoperatively. The complete success rates were higher in Group 1 than in Group 2 at 3 months ( = 0.008), 6 months ( = 0.01), and 12 months ( = 0.004) postoperatively, as were the respective qualified success rates ( = 0.04, = 0.0007, and = 0.001). The pooled estimate indicated lower antiglaucoma medication use in Group 1, especially at 1 month postoperatively ( = 0.003).
Conclusions: Microcatheter-assisted circumferential trabeculotomy resulted in excellent intraocular pressure control, higher success rates, and the utilization of less medication than conventional trabeculotomy for childhood glaucoma. Therefore, microcatheter-assisted circumferential trabeculotomy may be recommended as the initial procedure for the treatment of childhood glaucoma.
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http://dx.doi.org/10.1155/2020/3716859 | DOI Listing |
J AAPOS
January 2025
Department of Ophthalmology and Visual Sciences, University of Maryland School of Medicine, Baltimore, Maryland. Electronic address:
We report the use of the Harms trabeculotome to facilitate 360° microcatheter advancement during illuminated microcatheter-assisted circumferential trabeculotomy (IMCT) ab externo in a 3-month-old infant with bilateral primary congenital glaucoma who required repeat surgery. The illuminated microcatheter was advanced 270°, from 9 to 6 o'clock; however, a focal blockage occurred, and, despite viscodilation, further advancement was not possible. The surgeon introduced a right Harms trabeculotome in the opposite direction, counterclockwise through the same scleral flap.
View Article and Find Full Text PDFBMC Ophthalmol
April 2024
Department of Ophthalmology, Peking University Third Hospital, 49 North Garden Road, Haidian District, Beijing, 100191, China.
Background: Aniridia is a rare eye disorder with a high incidence of glaucoma, and surgical intervention is often needed to control the intraocular pressure (IOP). Here, we reported a case of illuminated microcatheter-assisted circumferential trabeculotomy (MAT) performed on an aniridic glaucoma patient following a previous failed angle surgery. The surgical procedures for aniridic glaucoma were also reviewed.
View Article and Find Full Text PDFAm J Ophthalmol
December 2023
From the State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases (L.F., Y.Z., S.L., L.C., P.L., Y.Z., X.L.), Guangzhou, China. Electronic address:
Purpose: To evaluate the outcomes of microcatheter-assisted trabeculotomy (MAT) in childhood glaucoma (primary congenital glaucoma [PCG], juvenile open-angle glaucoma [JOAG], and secondary childhood glaucoma [SCG]) after failed glaucoma surgery.
Design: Retrospective interventional case series.
Methods: Patients with childhood glaucoma who underwent MAT after failed glaucoma surgery with at least 12 months of follow-up were evaluated.
Int J Ophthalmol
May 2023
Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida 33136, USA.
Aim: To analyze and calculate the relative cost of various childhood glaucoma surgical interventions per mm Hg intraocular pressure (IOP) reduction ($/mm Hg).
Methods: Representative index studies were reviewed to quantitate the reduction of mean IOP and glaucoma medications for each surgical intervention in childhood glaucoma. A US perspective was adopted, using Medicare allowable costs to calculate cost/mm Hg IOP reduction ($/mm Hg) at 1y postoperatively.
Int J Surg
April 2023
Department of Ophthalmology, Seoul National University Hospital.
Background: Timely and proper intraocular pressure (IOP) management is vital to the prevention of visual impairment in children with primary congenital glaucoma (PCG). Although various surgical interventions have been proposed, no well-founded evidence exists on their comparative efficacies. We aimed to compare the efficacies of surgical interventions for PCG.
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