Dr.Mandal A K

Abstract

Stretching of limbus in an enlarged globe poses difficulty in identifying anatomical landmarks in advanced PCG. The present video highlights the surgical technique of primary trabeculotomy-trabeculectomy with Ologen implant in a 6-month old infant with advanced PCG (corneal diameter of 14mm). The surgical technique involved exploration of Schemm’s canal under a partial thickness superficial triangular scleral flap and performing ab-externo trabeculotomy with a metal trabeculotomy probe, followed by completion of trabeculectomy and iridectomy in a standard manner. Subsequently, the scleral flap was sutured back with one 10-o’ nylon suture at the apex. Finally, Ologen implant was placed over the sclera and conjunctival closure was done with a running suture using 8-o’ vicryl. Six months postoperatively, the infant had good IOP control and moderately elevated bleb with typical microcystic changes. The tips and tricks of the surgical technique have been explained elegantly in this video.