AIM:To evaluate the clinical effect of viscocanalostomy combined with 90°trabeculotomy in patients with primary congenital glaucoma(PCG).

METHODS:A total of 37 patients(50 eyes)with primary congenital glaucoma were included in the prospective and randomized trial. These patients were divided into two groups, the study group and the contral group. Viscocanalostomy combined with 90° trabeculotomy was performed in 25 eyes as the study group and 180° trabeculotomy in the other 25 eyes as the control group. The outcomes were measured respectively, including preoperative and postoperative intraocular pressure(IOP), corneal diameter and cup/disc ratio detected by Schiots tonometer, compass and ophthalmoscope respectively when patients were under sedation by chloralic hydras coloclysis. All patients were followed up at 1wk, 1, 3 and 6mo.

RESULTS:IOP decreased respectively from preoperative 30.74±4.68mmHg in the study group and 31.96±5.15mmHg in the control group to postoperative 7.51±3.68 and 8.47±2.66mmHg, 11.79±1.84 and 13.88±6.32mmHg, 13.97±2.76 and 15.74±3.20mmHg, 14.51±0.97 and 16.51±2.44mmHg at 1wk, 1, 3 and 6mo. The differences were statistically significant(P<0.01).The postoperative corneal diameter of study group decreased significantly at 3mo after operation(P<0.05). The average cup/dish ratio decreased in 22 eyes, did not progress in 28 eyes. The patients with successful operation had less cup/dish ratio(0.60±0.24)than that(0.72±0.19)before operation(P=0.007). In the 50 eyes, there was anterior chamber hemorrhage in 11 eyes(22%), which was not related to the decrease of IOP after operation. The rest patients had no complications, such as shallow anterior chamber, hypotonia, Descemet's membrane detachment, choroidal detachment, prolapse of vitreous, synechia and intraocular infection.

CONCLUSION:Viscocanalostomy combined with 90° trabeculotomy can improve the success rates in the patients with PCG, including lowering the postoperative mean IOP and decreasing the complication rates.