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Submitted: 2023-11-14
DOI: 10.35119/myjo.v7i1.402
Original Articles
Published: 2025-07-15

Surgical outcome of trabeculotomy in congenital glaucoma patients in a tertiary hospital in Malaysia

Department of Ophthalmology and Visual Science, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia; Department of Ophthalmology, Hospital Kuala Lumpur, Kuala Lumpur, Malaysia
Department of Ophthalmology, Hospital Kuala Lumpur, Kuala Lumpur, Malaysia
University of Malaya Eye Research Centre (UMERC), Department of Ophthalmology, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
Department of Ophthalmology, Hospital Kuala Lumpur, Kuala Lumpur, Malaysia
Department of Ophthalmology and Visual Science, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia
buphthalmos congenital glaucoma goniotomy trabeculotomy

Abstract

Purpose: To evaluate the surgical success rate of trabeculotomy in congenital glaucoma patients.

Study design: Retrospective observational study.

Methods: A total of 44 eyes of 26 patients with congenital glaucoma, either primary or secondary causes, who underwent trabeculotomy in Hospital Kuala Lumpur between January 2012 and July 2019 were retrospectively studied. Preoperative and postoperative intraocular pressure (IOP), corneal clarity and diameter, optic disc cupping, visual acuity and postoperative refractive error, success rate and complications were evaluated. Kaplan-Meier survival analysis was applied to evaluate surgical success rate at 1 year and 2 years postoperative.

Results: Twenty-seven (61.4%) eyes were diagnosed as primary congenital glaucoma, and 17 (38.6%) eyes were secondary glaucoma. The median age at the time of trabeculotomy was 3.9 months (IQR: 4.5 months). The cumulative surgical success rate at 1 year and 2 years postoperative was 72.7% and 50%, respectively. At final visit, the mean IOP was significantly reduced from 32.8 ± 12 mmHg to 18.2 ± 8.3 mmHg (p < 0.001). Mean number of antiglaucoma medications was also reduced from 1.6 ± 1.2 to 0.9 ± 1.0 (p = 0.001), with 21 (47.7%) eyes free of medication. Mean best-corrected visual acuity improved from 2.6 ± 0.5 to 1.3 ± 1.0 logMAR (p < 0.001). No severe intraoperative or postoperative complications were seen. At the 2-year follow-up, 5 eyes (11.4%) developed progressive optic disc cupping, and 10 eyes (22.7%) developed high myopia.

Conclusions: Trabeculotomy is a successful surgery for congenital glaucoma patients with a low complication rate.