Gonioscopy-assisted Transluminal Trabeculotomy in a Pediatric Patient With Steroid-induced Glaucoma

J Glaucoma. 2019 Oct;28(10):e156-e158. doi: 10.1097/IJG.0000000000001326.

Abstract

Purpose: To report a case of successful intraocular pressure (IOP) reduction after a 360-degree gonioscopy-assisted transluminal trabeculotomy (GATT) using the iTrack catheter in a patient with steroid-induced glaucoma as a result of treatment of vernal keratoconjunctivitis (VKC).

Materials and methods: Case report.

Results: An 8-year-old male individual with a long-standing history of VKC, treated with topical steroids, developed elevated IOP and glaucoma in the right eye despite maximum topical glaucoma therapy. Reducing the steroid was not a viable option given the severity of VKC. A 360-degree GATT was successfully performed and IOP has been maintained off all glaucoma drops.

Conclusions: GATT is a viable option for steroid-induced glaucoma in the pediatric population. This obviates the need for riskier, more invasive conjunctival-based procedures.

Publication types

  • Case Reports

MeSH terms

  • Anti-Allergic Agents / therapeutic use
  • Antihypertensive Agents / therapeutic use
  • Child
  • Conjunctivitis, Allergic / drug therapy
  • Drug Therapy, Combination
  • Follow-Up Studies
  • Glaucoma, Open-Angle / chemically induced*
  • Glaucoma, Open-Angle / physiopathology
  • Glaucoma, Open-Angle / surgery*
  • Glucocorticoids / adverse effects*
  • Gonioscopy / methods*
  • Humans
  • Immunosuppressive Agents / therapeutic use
  • Intraocular Pressure / physiology
  • Loteprednol Etabonate / adverse effects*
  • Male
  • Retrospective Studies
  • Surgery, Computer-Assisted*
  • Trabeculectomy / methods*
  • Treatment Outcome

Substances

  • Anti-Allergic Agents
  • Antihypertensive Agents
  • Glucocorticoids
  • Immunosuppressive Agents
  • Loteprednol Etabonate