Which of the following is the preferred initial surgical treatment for primary congenital glaucoma (trabeculodysgenesis) in an infant?

• A Trabeculectomy with mitomycin-C
• B Goniotomy or trabeculotomy ✓
• C Tube-shunt implantation (Ahmed valve)
• D Cyclodiode laser photocoagulation

Explanation

Primary congenital glaucoma is caused by isolated trabeculodysgenesis (abnormal trabecular meshwork with absent or rudimentary Schlemm's canal development). The surgical treatments of choice are goniotomy (direct incision of the trabecular meshwork under gonioscopic view) or trabeculotomy (threading a probe through Schlemm's canal and tearing the inner wall into the anterior chamber). Both procedures relieve the trabecular obstruction and achieve good IOP control in 70–90% of cases as primary surgery. Trabeculectomy is reserved for cases where angle surgery fails.

Reference: Khurana Comprehensive Ophthalmology, 7th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.