Comparison of 360-degree versus traditional trabeculotomy in pediatric glaucoma

PURPOSE To compare intraocular pressure (TOP) control of pediatric glaucoma patients undergoing traditional trabeculotomy (<360 degrees or partial) with those receiving 360-degree circumferential trabeculotomy. METHODS The medical records of pediatric glaucoma patients receiving trabeculotomy at a single institution from 2000 to 2012 were retrospectively reviewed. Patients were divided into two groups: a traditional trabeculotomy group and 360-degree trabeculotomy group. TOP at baseline and at 1, 3, 6, and 12 months' follow-up were compared within and each groups. RESULTS A total of 77 eyes of 56 patients (age at surgery, 1.52 +/- 2.68 years) in the traditional group and 14 eyes of 10 patients in the 360-degree group (age at surgery, 0.61 +/- 0.42 years) were included. Mean baseline TOP was similar in both groups (traditional, 28.75 +/- 8.80 mm Hg; 360-degree, 30.35 +/- 6.04 mm Hg; t test; P = 0.43). Mean 1-year TOP was 17.05 +/- 5.92 mm Hg in the traditional group and 11.0 +/- 2.31 mm Hg in the 360-degree group. At 1-year, the surgical success rate was 58.44% in the traditional group and 85.71% in the 360-degree group; 32 eyes in the former and 2 eyes in the latter required another glaucoma procedure within 1 year for TOP control. For both groups, compared to baseline values, TOP decreased significantly with all postoperative measurements (paired t test, all P < 0.01). The 360-degree group had significantly lower TOP compared to the traditional group at 1-year (t test, P < 0.01). CONCLUSIONS Both 360-degree and traditional trabeculotomy significantly reduced TOP in children through 1 year's follow-up, although the former procedure shows better 1-year postoperative TOP control, with higher rate of surgical success.