• Main
  • Useful links
  • Information for Contributors
  • About
  • Editorial board

  • Article
    N.gar A. Hasanova, Elmar M. Kasimov


    About the author: N.gar A. Hasanova, Elmar M. Kasimov
    Type of article Scentific article
    Annotation In our study, we wanted to see whether combined trabeculotomy-trabeculectomy with subconjuntival implantation of collagen matrix implant lead to further lowering of IOP and improve success rate as compared to combined trabeculotomy-trabeculectomy alone in eyes with primary congenital glaucoma. Methods. It was a prospective randomized control study. The sample was 20 eyes and out of them 4 of them were bilateral and 12 were unilateral cases. The study was done from September 2012 to June 2013. Combined trabeculotomy-trabeculectomy was performed in 10 eyes (Group 1) and combined trabeculotomy-trabeculectomy with subconjunctival collagen matrix implant (Ologen, Biogen Idec) implantation in 10 eyes (Group 2). Examination was done under general anesthesia at 15 days, 3 month and 6 months intervals. Results. The change of IOP was significant when the preoperative IOP was compared with postoperative IOP in both the groups and the trend of IOP was comparable in both the groups. In combined trabeculotomy-trabeculectomy group (Group 1) success was seen in 80% (n=8 ) of the patients among them 60% (n=6) showed IOP control without any medication and 20% (n=2) showed IOP control with one medication and 20% (n=2) had more than the IOP that is required for success. In combined trabeculotomy-trabeculectomy with subconjunctival collagen matrix implantation group (Group 2), 90% (n=9) showed success. Among them 80% (n=8) showed control of IOP without any medication and 10% (n=1) showed control of IOP with one medication and 10% (n=1) had more than the IOP that is required for success. Conclusion. Small sample, limited period of follow-up (6 months) makes it difficult to deduce firm conclusions. The results of both the groups were comparable and both the procedures can be taken up as primary procedures in case of congenital glaucoma. Larger studies with long-term follow-up are required to deduce firm conclusions.
    Tags primary congenital glaucoma, combined trabeculotomy-trabeculectomy, collagen matrix
    • Al-Hazmi A. Effectiveness and complications of mitomycin-C use during pediatric glaucoma surgery / A. Al-Hazmi, J. Zwaan, A. Awad // - Ophthalmology – 1998, Vol.105, P. 1915-1920.
    • Broughton W.L. An analysis of treatment of congenital glaucoma by goniotomy / W.L. Broughton, M.M. Parks // Am J Ophthalmol – 1981, Vol.91, P. 566-572.
    • Beck A.D. Lynch MG. 360º trabeculotomy for primary congenital glaucoma / A.D. Beck // Arch Ophthalmol - 1995,Vol.113, P.1200-1202.
    • Christofer J. Epidemiology and pathophysiology of congenital glaucoma / J. Christofer, H. Dickens, D. Hoskins // The Glaucomas – 1996, Vol.;2, P.729-738.
    • Dietlein T.S. Prognosis of ab externo surgery for primary congenital glaucoma / T.S. Dietlein, P.C. Jacobi, G.K. Krieglstein // Br J Ophthalmol – 1999, Vol.83, P. 317-322.
    • Elder M. J. Combined trabeculotomy-trabeculectomy compared with primary trabeculectomy for congenital glaucoma / M. J. Elder // Br J Ophthalmol – 1994, Vol.78, P.745-748.
    • Ho C.L. Primary Congenital Glaucoma: 2004 update / C.L. Ho, D.S. Walton // J Paediatric Ophthalmol Strabismus – 2004, Vol.41, P.271-288.
    • Kwitko M. L. Glaucoma in infants and children (1st ed) / M. L. Kwitko // Appleton-Century Croffs, New York – 1973, 500p.
    • Kolker A. E. Congenital glaucoma. In: Becker-Schafer’s diagnosis and therapy of the glaucomas (5th ed) / A. E. Kolker, T. J. Hethering // St Louis’s: Mosby -1983, P.317-369.
    • Mullaney P.B. Combined trabeculotomy and trabeculectomy as initial procedure in uncomplicated congenital glaucoma / P.B. Mullaney, C. Selleck, A. Al-Awad [et al.] // Arch Ophthalmol – 1999, Vol.117, P. 457-460.
    • Mandal A.K. Safety and efficacy of simultaneous bilateral primary combined trabeculotomy-trabeculectomy for developmental glaucoma in India / A.K. Mandal, P.G. Bhatia, V.K. Gothwal [et al.] // - I ndian J Ophthalmol - 2002,Vol.50, P.13-19.
    • Mandal A. K. Long-term surgical and visual outcomes in Indian children with developmental glaucoma operated on within 6 months of birth / A.K. Mandal, P.G. Bhatia, A. Bhaskar [et al.] // Ophthalmology – 2004, Vol.111, P. 283-290.
    • Mandal A. K. Combined trabeculotomy and trabeculectomy in advanced primary developmental glaucoma with corneal diameter of 14mm or more / A.K. Mandal, J. Bhende, R. Nutheti [et al.] // - Eye – 2006, Vol. 20, P. 135-143.
    • Schaffer R. N. Prognosis of goniotomy in primary infantile glaucoma (trabeculodysgenesis) / R. N. Schaffer // - Trans Am Opthalmol Soc – 1982, Vol.80, P. 321-325.
    • Steven R. Sarkisian. Recent advances in glaucoma surgery- Clinical experiences of Ologen collagen matrix in over 1000 ocular surgeries / Steven R. Sarkisian. // WOC - 2012, Abu-Dhabi.
    • Walton D. S. Newborn primary congenital glaucoma: 2005 Update / D. S. Walton G. F. Katsavoundiou // MS J Paediatric Ophthalmol Strabismus – 2005, Nov-Dec, Vol.42(6), 332 p.
    Publication of the article «World of Medicine and Biology» №2(49) 1 part 2015 year, 008-013 pages, index UDK .7-007.681-089.843