Outcomes of 240-degree goniotomy in primary congenital glaucoma: a retrospective case series

To evaluate the safety and efficacy of 240-degree goniotomy (GT) in primary congenital glaucoma (PCG), including eyes with prior failed glaucoma surgery. A retrospective case series of consecutive PCG patients who underwent 240-degree GT was reviewed with a follow-up of at least 6 months. Outcome measures included intraocular pressure (IOP), number of antiglaucoma medications, and success rates at final follow-up. Complete success was defined as IOP ≤ 21 mmHg without medications or additional glaucoma surgery; qualified success as IOP ≤ 21 mmHg with or without medications and no reoperation. A total of 12 eyes of 9 patients were included. Median age at GT was 5.8 years (IQR, 5.3–6.8 years; range, 2.5–31.0 years), and 8 eyes (66.7%) were from male patients. After a mean follow-up of 15.4 ± 11.9 months (range, 6–49 months), IOP decreased from 31.7 ± 6.6 mmHg on 2.9 ± 0.9 medications preoperatively to 16.4 ± 4.5 mmHg on 1.4 ± 1.5 medications, with a 46.4% reduction in IOP ( P < 0.001). The complete and qualified success rates were 41.7% and 91.7%, respectively. There were no vision-threatening intraoperative or postoperative complications. This case series suggests that 240-degree GT is promising in treating PCG and those with prior glaucoma surgery. Not applicable.