Trabeculotomy Ab Interno With the Trab360 Device for Childhood Glaucomas.
Areaux Raymond G, Grajewski Alana L, Balasubramaniam Saranya, Brandt James D, Jun Amber, Edmunds Beth, Shyne Michael T, Bitrian Elena
AI Summary
Trab360 trabeculotomy for childhood glaucoma showed good success (67.4%), especially for primary congenital glaucoma (81%), with few complications, making it an effective and safe treatment option.
Abstract
Purpose
To report outcomes and complications of trabeculotomy ab interno using the Trab360 device (Trab360; Sight Sciences, Menlo Park, California, USA) in eyes with childhood glaucomas.
Design
Multicenter retrospective interventional case series.
Methods
Eyes with childhood glaucomas that underwent Trab360 with at least 3 months follow-up were evaluated. Postoperative intraocular pressure (IOP) less than or equal to 24 mm Hg with or without medications and no additional surgery defined success.
Results
Forty-six eyes of 41 patients were included. Median age at surgery was 12 months (range 1-325 months, mean 71 months); 54% prior to 20 months. A total of 48% were right eyes; 48% were male. Mean treatment was 290°. Median follow-up was 14.5 months (range 6-34 months, mean 16.2 months). Median preoperative IOP was 30 mm Hg (range 18-49 mm Hg, mean 30.9 mm Hg); median postoperative IOP was 18 mm Hg (range 5-40 mm Hg, mean 20.3 mm Hg]. Median number of preoperative glaucoma medications was 2.5 (range 0-5, mean 2.6); median number postoperatively was 1 (range 0-4, mean 1.6). Success was achieved in 67.4% (95% CI: 51.9%-80.0%) of eyes. Among 40 eyes for which Trab360 was the first glaucoma surgery, success rate was 70% (95% CI 53.3%-82.9%). Success was achieved in 81% (95% CI 57.4%-93.7%) of primary congenital glaucoma (PCG) eyes. Among 18 PCG eyes for which Trab360 was the first glaucoma surgery, success rate was 83.3% (95% CI 57.7%-95.6%). Two eyes (4.3%) suffered cyclodialysis. There were no other significant complications.
Conclusions
Trab360 success resembles literature on other angle surgeries for childhood glaucomas. Good surgical technique and caution in high-risk angles is imperative to avoid cyclodialysis. Our study is limited by the imperfections inherent in any retrospective analysis. Single-incision ab interno trabeculotomy with the Trab360 device is effective and safe for treating childhood glaucomas, especially PCG.
MeSH Terms
Shields Classification
Key Concepts5
Trabeculotomy ab interno using the Trab360 device achieved success in 67.4% (95% CI: 51.9%-80.0%) of eyes with childhood glaucomas.
For childhood glaucomas, when Trabeculotomy ab interno with the Trab360 device was the first glaucoma surgery, the success rate was 70% (95% CI 53.3%-82.9%).
Trabeculotomy ab interno using the Trab360 device achieved success in 81% (95% CI 57.4%-93.7%) of primary congenital glaucoma (PCG) eyes.
Among 18 primary congenital glaucoma (PCG) eyes for which Trabeculotomy ab interno with the Trab360 device was the first glaucoma surgery, the success rate was 83.3% (95% CI 57.7%-95.6%).
Two eyes (4.3%) suffered cyclodialysis as a complication of trabeculotomy ab interno using the Trab360 device in eyes with childhood glaucomas.
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