Trabeculotomy Ab Interno With the Trab360 Device for Childhood Glaucomas

Raymond G. Areaux, Alana L. Grajewski, Saranya Balasubramaniam, James D. Brandt, Amber Jun, Beth Edmunds, Michael T. Shyne, Elena Bitrian

Research output: Contribution to journalArticle

1 Scopus citations

Abstract

Purpose: To report outcomes and complications of trabeculotomy ab interno using the Trab360 device (Trab360; Sight Sciences, Menlo Park, California, USA) in eyes with childhood glaucomas. Design: Multicenter retrospective interventional case series. Methods: Eyes with childhood glaucomas that underwent Trab360 with at least 3 months follow-up were evaluated. Postoperative intraocular pressure (IOP) less than or equal to 24 mm Hg with or without medications and no additional surgery defined success. Results: Forty-six eyes of 41 patients were included. Median age at surgery was 12 months (range 1-325 months, mean 71 months); 54% prior to 20 months. A total of 48% were right eyes; 48% were male. Mean treatment was 290°. Median follow-up was 14.5 months (range 6-34 months, mean 16.2 months). Median preoperative IOP was 30 mm Hg (range 18-49 mm Hg, mean 30.9 mm Hg); median postoperative IOP was 18 mm Hg (range 5-40 mm Hg, mean 20.3 mm Hg]. Median number of preoperative glaucoma medications was 2.5 (range 0-5, mean 2.6); median number postoperatively was 1 (range 0-4, mean 1.6). Success was achieved in 67.4% (95% CI: 51.9%-80.0%) of eyes. Among 40 eyes for which Trab360 was the first glaucoma surgery, success rate was 70% (95% CI 53.3%-82.9%). Success was achieved in 81% (95% CI 57.4%-93.7%) of primary congenital glaucoma (PCG) eyes. Among 18 PCG eyes for which Trab360 was the first glaucoma surgery, success rate was 83.3% (95% CI 57.7%-95.6%). Two eyes (4.3%) suffered cyclodialysis. There were no other significant complications. Conclusions: Trab360 success resembles literature on other angle surgeries for childhood glaucomas. Good surgical technique and caution in high-risk angles is imperative to avoid cyclodialysis. Our study is limited by the imperfections inherent in any retrospective analysis. Single-incision ab interno trabeculotomy with the Trab360 device is effective and safe for treating childhood glaucomas, especially PCG.

Original languageEnglish (US)
Pages (from-to)178-186
Number of pages9
JournalAmerican Journal of Ophthalmology
Volume209
DOIs
StatePublished - Jan 2020

ASJC Scopus subject areas

  • Ophthalmology

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    Areaux, R. G., Grajewski, A. L., Balasubramaniam, S., Brandt, J. D., Jun, A., Edmunds, B., Shyne, M. T., & Bitrian, E. (2020). Trabeculotomy Ab Interno With the Trab360 Device for Childhood Glaucomas. American Journal of Ophthalmology, 209, 178-186. https://doi.org/10.1016/j.ajo.2019.10.014