Illuminated Microcatheter Passage Assisted Circumferential Trabeculotomy and Trabeculectomy (IMPACTT): An improved surgical procedure for Primary Congenital Glaucoma.

Purpose: To report an improved surgical procedure for primary congenital glaucoma (PCG).

Case Report: An apparently healthy 4-month-old male child was referred by an ophthalmologist with the preliminary diagnosis of congenital glaucoma. Office examination followed by evaluation under anaesthesia confirmed the diagnosis of advanced PCG in both eyes. Horizontal corneal diameter was 13.5 mm in both eyes and intraocular pressure was 36 mmHg in both eyes. The child was operated on both eyes in the same session. An illuminated microcatheter passage assisted circumferential trabeculotomy and trabeculectomy (IMPACTT) was performed. Two months postoperatively, the IOPs were 12 and 10 mmHg in the right and left eye, respectively, and the cornea was clear except for the presence of Haab's striae in both eyes. The child's visual acuity (binocularly) was 4 cycles/degree as recorded with Teller acuity cards.

Conclusions: Illuminated microcatheter passage assisted circumferential trabeculotomy and trabeculectomy (IMPACTT) is safe and effective and may represent an improved surgical procedure for the management of advanced PCG.