Trabeculotomy and goniotomy in congenital glaucoma - postoperative correlation of IOP with axial length growth
G. Meyer1, O. Schwenn2, F. Grehn1
Purpose: To investigate the correlation of postoperative intraocular pressure (IOP) with axial length growth in children who underwent either trabeculotomy (TO) or goniotomy (GO) as primary surgery for congenital glaucoma.
Methods: We retrospectively analyzed 37 eyes of 21 children with congenital glaucoma who underwent TO from 1992 to 1997 and 26 eyes of 16 children with congenital glaucoma who underwent GO from 1974 to 1993. IOP was checked with handheld applanation tonometry (Perkins). Axial length was measured by ultrasound. The data were retrospectively analyzed for a correlation of postoperative IOP reduction with postoperative axial length growth.
Results: Mean follow-up was 27.3 months in the TO-eyes and 37.1 months in the GO-eyes. Mean pretreatment IOP was 28.4±6.9 mmHg in the TO-eyes and 30.8±8.5 mmHg in the GO-eyes. Mean IOP at the end of follow-up was 17.5±5.8 mmHg (TO-eyes) and 17.4±10.2 mmHg (GO-eyes), respectively. Axial length growth was normalized (proportional or slowed down as compared to the nomogram of axial length growth) in 31 of the TO-eyes and 20 of the GO-eyes, and was increased in 6 of the TO-eyes and 6 of the GO-eyes at the end of follow-up. Regarding IOP regulation, 9 of 37 TO-eyes did not fulfill the IOP-success-criterion (IOP=21 mmHg and IOP-drop =20%) at the end of follow-up. 3 of these eyes had also increased axial length growth; 6 eyes had normalized axial length growth, but 4 of these eyes had only borderline IOP-elevation. 6 of 26 GO-eyes did not fulfill the IOP-success-criterion at the end of follow-up. 5 of these eyes also had increased axial length growth; 1 eye had decreased axial length growth.
Conclusion: These data show a remarkably good correlation of postoperative IOP with postoperative axial length growth.
1Universitäts-Augenklinik, Josef-Schneider-Str. 11, D-97080 Würzburg