Long-Term Update On Deep Sclerectomy Vs. Combined Trabeculotomy Trabeculectomy In Cases With Congenital Glaucoma

To compare the efficacy and safety of Deep Sclerectomy Vs. Combined Trabeculotomy Trabeculectomy on the long-term.

The current study adopts a two-arms clinical trial design, where a series of bilaterally affected congenital glaucoma cases were recruited. All cases were conducted by senior consultants based on a standardized protocol.

A clinical trial design. Bilateral cases were recruited, where OD was conducted as DS and OS as CTT. Clinical indices were evaluated, preoperative, and at 3, 6, 12, 24 months & the last follow-up visit. The change in clinical glaucoma indices was monitored and two main comparisons were done, to compare pre- to post- intervention in each arm, as well as compare findings from both arms.

A total of 140 eyes of 70 patients were recruited. Subjects were in the mean (SD) age of 1.6 (2.3), months, 29 (41.4%) males, and 41 (58.6%) females. In both groups, the IOP was significantly reduced (p <0.0001). The complete success rate was 49 (71%) in the DS eyes, while it was 35 (51.5%) in the CTT eyes (p=0.016), while the overall success rate was 58 (82.9%) 41 (58.6%) in the DS and CTT eyes, respectively, (p=0.001). The intraoperative complication rate was 3 (4.3%) in the DS, while it was 17(24.3%) in the CTT eyes (p=0.002). The postoperative complication rate was 6 (8.6%) in the DS eyes while it was 21(30.0%) in the CTT eyes (p=0.005).

Deep sclerectomy is superior to the combined trabeculotomy/trabeculectomy in terms of both efficacy and safety as assessed by the increased success rate and the lower rate of complications.