To investigate the efficacy and safety of microcatheter-assisted 360° trabeculotomy (MAT) in the treatment of glaucoma following congenital cataract surgery (GFCS).

From April 2015 to February 2022, 27 patients (30 eyes) with secondary glaucoma after congenital cataract surgery who underwent MAT at the Beijing Tongren Eye Center of Beijing Tongren Hospital affiliated to Capital Medical University were collected. Among them, there were 18 males (20 eyes) and 9 females (10 eyes) with an average age of (6.9±5.9) years (ranged from 8 months to 20 years). All patients were treated with MAT. The intraocular pressure (IOP) and the number of eyes requiring different drugs were recorded before and after operation for 1 day, 1 week, 1 month, 3 months and 6 months. Among them, the IOP of patients at each time point conform to normal distribution and was represented by (±s); the number of eyes requiring medication were represented by cases and percentage. The IOP of patients at each time point was compared using single-factor repeated measurement analysis of variance, and the number of eyes required for medication at each time point was compared using the generalized estimation equation method. The total success rate and complete success rate of the operation at each time point were calculated and compared using the generalized estimation equation method.

The IOP of patients at each time point were (35.97±7.67) mmHg (1 mmHg=0.133 kPa), (14.83±6.54) mmHg, (16.40±5.01) mmHg, (17.90±4.97) mmHg, (17.53±4.13) mmHg and (18.00±3.34) mmHg, respectively. The overall difference of IOP between preoperative and postoperative patients at each time point was statistically significant (F=92.75, P<0.05). The difference of IOP between preoperative and postoperative patients at each time point was statistically significant (t=11.49, 10.08, 9.52, 9.87, 8.54; P<0.05). The difference of IOP between postoperative patients at each time point was not a statistically significant (t=0.54, 1.56, 1.21, 1.62, 0.85, 0.78, 0.90, 0.62, 0.47, 0.65; P>0.05). There were 19 cases (22 eyes), 3 cases (3 eyes), 1 case (1 eye), 2 cases (2 eyes), 2 cases (2 eyes), 0 cases (0 eye), 18 cases (20 eyes), 3 cases (3 eyes), 2 cases (2 eyes) and 3 cases (3 eyes), 2 cases (2 eyes), 0 case (0 eye), 18 cases (20 eyes), 4 cases (4 eyes), 2 cases (2 eyes), 3 cases (3 eyes), and 1 case (1 eye), and 0 case (0 eye) , 17 cases (19 eyes), 4 cases (4 eyes), 1 cases (1 eyes), 5 case (5 eye) and 1 case (1 eye), 0 case (0 eye), accounting for 73.33%, 10.00%, 3.33%, 6.67%, 6.67% and 0.00%, 66.67%, 10.00%, 6.67%, 10.00%, 6.67% and 0.00%, 66.67%, 13.33%, 6.67%, 10.00%, 3.33% and 0.00%, 63.33%, 13.33%, 3.33%, 16.67%, 3.33% and 0.00%, respectively, who used 0, 1, 2, 3, 4, and 5 eyes medications after operation for 1 week, 1 month, 3 months and 6 months. There was a statistically significant difference between them (χ²=30.26, 61.05, 55.36, 48.86; P<0.05). There was a statistically significant difference between the patients who needed drugs after operation for 1 month, 3 months and 6 months (χ²=72.08, 76.05; P<0.05). There was statistically significant difference between those who needed drugs after operation for 3 months and those who needed drugs after operation for 6 months (χ²=94.80, P<0.05). Of the 27 patients (30 eyes), there were 3 patients (3 eyes), 4 patients (4 eyes), 4 patients (4 eyes) and 4 patients (4 eyes) with basically successful operation after 1 week, 1 month, 3 months and 6 months, accounting for 10.00%, 13.33%, 13.33% and 13.33% respectively. The total successful cases were 19 cases (22 eyes), 17 cases (19 eyes), 17 cases (19 eyes) and 16 cases (18 eyes), accounting for 73.33%, 63.33%, 63.33% and 60.00%, respectively. There was not a statistically significant difference in the complete success rate of surgery at each time point (χ²=2.90, P>0.05). The total success rate of operation at each time point was 83.33%, 76.67%, 76.67% and 73.33% respectively. There was not a statistically significant difference in the total success rate of operation at each time point (χ² =1.42, P>0.05).

MAT is effective and safe in the treatment of GFCS.