A neonate presents with buphthalmos, excessive tearing, and photophobia. IOP is 28 mmHg in both eyes. The preferred initial surgical treatment for primary congenital glaucoma (PCG) is:
- A Trabeculectomy with mitomycin C
- B Goniotomy or trabeculotomy ✓
- C Ahmed glaucoma valve implantation
- D Cyclodiode laser photocoagulation
Correct answer: B. Goniotomy or trabeculotomy
Explanation
Primary congenital glaucoma results from developmental anomaly at the trabecular meshwork (membrane of Barkan overlying the angle). Goniotomy (when cornea is clear) or trabeculotomy (when cornea is hazy) are the surgeries of choice, targeting the primary pathology at the trabecular angle. Success rates exceed 80-90% when performed early. Trabeculectomy with MMC is reserved for failed cases; drainage devices for refractory cases.
Reference: Khurana Comprehensive Ophthalmology, 7th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
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