In congenital glaucoma, the first-line surgical treatment is:
- A Trabeculectomy with mitomycin C
- B Goniotomy (where cornea is clear) or trabeculotomy ✓
- C Topical latanoprost monotherapy
- D Laser peripheral iridotomy
Correct answer: B. Goniotomy (where cornea is clear) or trabeculotomy
Explanation
Primary congenital glaucoma results from dysgenesis of the trabecular meshwork (Barkan's membrane). First-line surgical treatment is goniotomy (direct incision of the trabecular meshwork under gonioscopic view) when the cornea is clear enough, or trabeculotomy (external approach using a trabeculotome passed through Schlemm's canal) when the cornea is hazy. Both create direct communications between the anterior chamber and Schlemm's canal. Medical therapy is temporising until surgery.
Reference: Khurana Comprehensive Ophthalmology, 7th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.