Comparative Evaluation of Trabeculotomy-Trabeculectomy with Mitomycin C vs Trabeculectomy, with Mitomycin C for Primary Congenital Glaucoma

Objective: To compare the outcomes of combined trabeculotomy-trabeculectomy with mitomycin C vs trabeculectomy with mitomycin C alone in the treatment of primary congenital glaucoma.Design: Prospective randomized double blind study.Materials and methods: A total of 18 patients were involved in which 14 of them were bilateral and four cases being unilateral. Randomization was done and combined trabeculotomy-trabeculectomy with mitomycin C was performed in 16 eyes (Group 1) and trabeculectomy with mitomycin C in 16 eyes (Group 2). Pre- and postoperative intraocular pressures (IOP), corneal clarity and diameters, visual acuity, success rate, bleb characteristics and complications were evaluated.Results: Mean preoperative IOP was 24.87 + 6.81 in Group 1 and 27.25 + 4.55 in Group 2, which reduced to 12.5 + 4.9 and 13.12 + 5.36 respectively. Seventy-five percent of cases in Group 1 and 81.25% of cases in Group 2 showed IOP < 18 mm Hg at the end of 6 months (p < 0.05). Total of 87.5% of the eyes had photophobia in Group 1 and 93.75% in Group 2 and all of them were relieved of photophobia which was assessed 3 weeks postsurgery. There was no sight threatening intraoperative and postoperative complications. No anesthetic complications were noted.Conclusion: The results of both the groups were comparable and both the procedures can be taken up as primary procedures in case of congenital glaucoma.