# 360° trabeculotomy ab externo with double access for the treatment of congenital glaucoma

## TL;DR

This study introduces a new surgical technique for treating congenital glaucoma in children, showing it effectively lowers eye pressure with minimal complications.

## Contribution

A novel 360° trabeculotomy ab externo with double access technique is proposed for pediatric glaucoma.

## Key findings

- The procedure reduced intraocular pressure from 25 mmHg to 10 mmHg on average.
- No patients required hypotensive eye drops after surgery.
- Hyphema was the most common complication but resolved within a week.

## Abstract

This study aims to describe the technique, feasibility, efficacy, and safety
of 360° trabeculotomy ab externo with double access for the treatment of
congenital glaucoma.

This paper provides a detailed description of the 360° trabeculotomy ab
externo with double access used to treat pediatric glaucoma. The
postoperative outcomes of six eyes from six patients who underwent this
procedure for primary and secondary congenital glaucoma are also
reported.

Six eyes from six patients were included in this study. The median age of the
patients at the time of surgery was 1.25 yr (range: 0.27-5.41 yr). The mean
preoperative intraocular pressure was 25 ± 5.87 mmHg (range: 18-35
mmHg). At baseline, the mean number of hypotensive eye drop medications used
was 2 ± 0.63. Postoperatively, the mean intraocular pressure
decreased to 10 ± 2.20 mmHg (range: 9-14 mmHg), and none of the
patients required hypotensive eye drops. The most common postoperative
complication was hyphema, observed in one case on the first postoperative
day; however, it resolved within 7 days.

The 360° trabeculotomy ab externo with double access is a valuable addition
to the surgical options for pediatric glaucoma. This technique facilitates a
complete 360° ab externo opening of the trabecular meshwork while enhancing
surgical safety.