Neodymium-YAG laser goniotomy vs surgical goniotomy. A preliminary study in paired eyes.

Goniotomy and trabeculotomy are two widely accepted modalities of treatment for primary congenital/infantile glaucoma. Both procedures may be associated with complications. We treated 10 patients with bilateral, symmetrical congenital/infantile glaucoma and clear corneas. One eye of each patient underwent surgical goniotomy under general anesthesia, and the other was treated by neodymium-YAG laser goniotomy under oral chloral hydrate sedation (average energy, 76.6 mJ). Mean pretreatment intraocular pressure in the surgical goniotomy group was 28.4 mm Hg and in the laser goniotomy group it was 29.5 mm Hg, decreasing to 23.6 and 23.1 mm Hg, respectively, following treatment. There was a strong positive correlation (r = .81) between the percent of intraocular pressure change after laser treatment (mean, -14.4%) and that after surgery (mean, -14.3%). Our preliminary results indicate that neodymium-YAG laser goniotomy is an effective, noninvasive alternative to surgical goniotomy.