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In this video, a 7-month-old patient presenting with primary congenital glaucoma and corneal clouding has an ab externo trabeculotomy performed on her left eye. The procedure begins with subconjunctival dissection and formation of a temporal scleral flap to locate the back wall of Schlemm’s canal (SC). A 270-degree circumferential trabeculotomy is performed with an illuminated microcatheter. The microcatheter is blocked from completing a full 360 degree pass due to scarring from a previously failed superior trabeculectomy. A scleral cutdown is used to retrieve the microcatheter. Another 40 degrees of trabecular meshwork (TM) is incised in the opposite direction using a metal trabeculotome.
We do not have any conflicts to disclose.
1. Edmunds B, Beck AD, Hoffmann E, Grehn F. Angle Surgery: Trabeculotomy. In: Grajewski AL, Bitrian E, Papadopoulos M, Freedman SF, eds. Surgical Management of Childhood Glaucoma: Clinical Considerations and Techniques. Springer International Publishing; 2018:57-78. doi:10.1007/978-3-319-54003-0_5
2. Rojas C, Bohnsack BL. Rate of Complete Catheterization of Schlemm’s Canal and Trabeculotomy Success in Primary and Secondary Childhood Glaucomas. Am J Ophthalmol. 2020;212:69-78. doi:10.1016/j.ajo.2019.11.029
3. Weinreb RN, Grajewski A, Papadopoulos M, Grigg J, Freedman S. World Glaucoma Association (WGA) Consensus Series 9 - Childhood Glaucoma. Amsterdam: Kugler Publications; 2013:149.
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This is approved for 0.5 AMA PRA Category 1 Credit™ via CineMed (ACCME / ACPE / ANCC). The two viewing modes are different — pick what fits your time.
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