Journal of Ophthalmology / 2013 / Article / Tab 1

Review Article

Current Surgical Options for the Management of Pediatric Glaucoma

Table 1

Summary of the advantages and disadvantages for either procedure.

GoniotomyTrabeculotomy
ProsConsProsCons

SimplerRequires a degree of corneal clarity It can be done even with cloudy corneaMore elaborate procedure (it requires accurate identification of Schlemm’s canal)

Faster procedureIntroduction of sharper instruments across the anterior chamber (higher risk of damage to intraocular structures), and an assistant is needed to tilt the patient’s headNo need to introduce sharp instruments across anterior chamberMore lengthy procedure

Does not disturb conjunctivaBetter success before age 3It can be converted to trabeculectomyIt disturbs conjunctiva

Direct visualization of TM Eliminates entire TM as obstacle and works in situations with multiple mechanisms exist, such as impermeability of inner wall or collapse of Schlemm’s canal

More targeted cutting of abnormal tissue in primary congenital glaucomaSuccess reported even in patients older than 3

May repeat one or more timesMay repeat only one time

If the cornea is sufficiently clear it is usually possible to identify target tissue Not always able to find Schlemm’s canal (3–15% cases)

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