Microkatheter-geassisteerde trabeculotomie versus conventionele partiële trabeculotomie bij primair congenitaal glaucoom: een retrospectieve vergelijkende studie

Microcatheter-assisted trabeculotomy versus conventional partial trabeculotomy for primary congenital glaucoma: a retrospective comparative study Introduction: Primary congenital glaucoma is a rare condition characterized by abnormal development of the trabecular meshwork, leading to elevated intraocular pressure (IOP) and potential blindness at a young age. Angle surgery is the mainstay of treatment. Methods: In this single-center retrospective comparative study, we evaluated the effectiveness of microcatheter-assisted trabeculotomy (MCT) versus conventional partial trabeculotomy (CPT). Results: A total of 18 patients (31 eyes) were included: 17 eyes underwent CPT and 14 eyes MCT. Complete surgical success (IOP < 18 mmHg without medication) at 6 months was 57.1% in the MCT group and 50% in the CPT group (p = 0.680), and at 1 year 85.7% and 50%, respectively (p = 0.173). Qualified success (IOP < 18 mmHg with medication) showed comparable results at 6 and 12 months. In the first postoperative week, IOP was significantly lower in the MCT group (16.4 mmHg vs 30.1 mmHg; p = 0.027). Thereafter, IOP values evolved toward similar levels in both groups, with comparable percentage reductions at 6 and 12 months. Several marked early postoperative IOP spikes were observed in the CPT group. The use of antiglaucoma medication was consistently lower in the MCT group at all time points. Over a 12-month follow-up, a trend toward fewer reinterventions was observed after MKT compared to CPT (2 vs 12; p = 0.069). Discussion: These findings suggest that circumferential microcatheter-assisted trabeculotomy is a safe and effective treatment option for patients with primary congenital glaucoma, offering favorable early IOP control and potentially reducing the need for additional surgical interventions.