Trabeculotomy for Congenital Glaucoma

Trabeculotomy for Congenital Glaucoma

Surgery Overview

Trabeculotomy is a surgical procedure much like trabeculectomy. A piece of tissue in the eye's drainage angle is removed to create an opening. This new opening allows fluid (aqueous humor) to drain out of the eye. Trabeculotomy is a surgery for children only.

What To Expect

After surgery, drops that tighten (constrict) the pupil are used to keep the iris, the colored part of the eye, from blocking the new opening.

Why It Is Done

Trabeculotomy is a good choice for children who have congenital glaucoma when the clear covering (cornea) over the iris is cloudy.

For children, trabeculotomy or goniotomy are preferred over trabeculectomy, because they are less invasive and less likely to cause cataracts. They also do a better job of lowering eye pressure in children who have glaucoma.

How Well It Works

Trabeculotomy is successful for more than 80 out of 100 children whose glaucoma was not present at birth.footnote 1

Risks

The most common problem after trabeculotomy is scarring of the new opening in the eye. Scarring prevents fluid from draining out of the eye. Other complications of surgery may include:

  • Severe blurring of vision for several weeks (common).
  • Bleeding in the eye.
  • Extremely low pressure in the eye, which may result in blurred vision from clouding of the lens (cataract) or fluid buildup under the nerve layer (retina).
  • Sudden, permanent loss of central vision.
  • Infection in the eye.
  • High pressure in the eye, causing the space in the front part of the eye (anterior chamber) to collapse. This condition is called malignant glaucoma and is rare.
  • Continued changes in the optic nerve (at the back of the eye) caused by glaucoma.

What To Think About

Some children with congenital glaucoma need more than one surgery to control the high pressure in their eyes.

Surgery is more difficult and less likely to be successful for children who have severe congenital glaucoma.

Medicines may still be needed to control pressure in the eyes after surgery.

References

Citations

  1. Salim S, Walton D (2009). Goniotomy and trabeculotomy. In M Yanoff, JS Duker, eds., Ophthalmology, 3rd ed., pp. 1241–1245. Edinburgh: Mosby Elsevier.

Credits

Current as ofJuly 17, 2018

Author: Healthwise Staff
Medical Review: Adam Husney, MD - Family Medicine
Christopher Joseph Rudnisky, MD, MPH, FRCSC - Ophthalmology

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