Dr. A. K. MANDAL

Abstract

The present video highlights the details of a novel surgical technique and results on a 4-month-old child with advanced primary congenital glaucoma (PCG). With the help of an illuminated microcatheter ab externo, circumferential trabeculotomy was performed. Then trabeculectomy was completed in the usual manner. In advanced cases of PCG, collector channels and distal outflow system are more likely to be malformed. Given this, angle surgery even in the form of circumferential trabeculotomy may prove to be suboptimal and necessitate addition of trabeculectomy that bypasses the distal outflow system. Hence, this novel technique – Microcatheter Passage Assisted Circumferential Trabeculotomy and Trabeculectomy (IMPACTT) was performed, and the outcome was satisfactory in terms of IOP control, corneal clarity, and visual development. This technique may represent the next step in the search for the best surgical treatment for advanced PCG.