Congenital Glaucoma-Treatment
If cornea is clear:
Goniotomy:
- Safer method, but rare in India as:
- Gonioscopy should be used to look at the angle
- As pt. usually comes to the doctor very late
- And the cornea is no clearer and hazier.
- In hazy cornea it is difficult to perform Goniotomy
- Barkan’s membrane is punctured by a needle allowing aqueous outflow through trabecular meshwork & helps in ↓IOP
If cornea is hazy:
Trabeculotomy
- Scleral approach to trabecular meshwork → small hole is made in trabecular meshwork→ Normal aqueous flow → ↓IOP
Trabeculotomy + Trabeculectomy (TRAB+TRAB)
- TRAB+TRAB →Along with a small hole, a piece of Trabecular mesh work is removed for the normal aqueous flow – ↓IOP
