Dilation and probing of Schlemm's canal and viscocanalostomy in pediatric glaucoma

Purpose: To describe the authors' experience using a novel surgical technique for treatment of childhood glaucoma. Methods: Medical records of 24 consecutive patients and 39 eyes that underwent dilation and probing of Schlemm's canal and viscocanalostomy between September 2002 and June 2008 were reviewed. Surgical success was defined as an intraocular pressure (IOP) of less than 23 mm Hg with or without glaucoma medication and without further surgical intervention. Results: Mean age at surgery was 66 ± 66 months, with a mean preoperative IOP of 40.4 ± 10.2 mm Hg. Surgical success was achieved in 27 of 39 eyes (69%) with an average follow-up of 22 months. In patients without history of previous surgery and the diagnosis of primary congenital or juvenile glaucoma, surgical success was achieved in 17 of 19 eyes (89%) with an average follow-up of 20 months. There were no serious surgical complications associated with this procedure. Conclusion: Goniosurgery with dilation and probing of Schlemm's canal in combination with viscocanalostomy appears to be a safe and effective surgical modality to lower IOP. The procedure appears to be most effective in surgically naïve primary congenital and juvenile glaucoma.