240-Degree Goniotomy Shows Promise for Primary Congenital Glaucoma in Small Case Series

The study reviewed consecutive patients with primary congenital glaucoma who underwent the procedure and had at least six months of follow-up. In total, 12 eyes of 9 patients were included. The median age at surgery was 5.8 years, with an interquartile range of 5.3 to 6.8 years and a full range spanning 2.5 to 31.0 years. Eight of the 12 eyes, or 66.7 percent, belonged to male patients.

After a mean follow-up of 15.4 plus or minus 11.9 months, ranging from 6 to 49 months, intraocular pressure fell from 31.7 plus or minus 6.6 mmHg before surgery to 16.4 plus or minus 4.5 mmHg at the final visit, a reduction of 46.4 percent that was statistically significant. The number of antiglaucoma medications dropped from 2.9 plus or minus 0.9 to 1.4 plus or minus 1.5 over the same period.

The researchers defined complete success as an intraocular pressure of 21 mmHg or lower without medications or additional glaucoma surgery, and qualified success as an intraocular pressure of 21 mmHg or lower with or without medications and no reoperation. By these criteria, the complete success rate was 41.7 percent and the qualified success rate was 91.7 percent at final follow-up.

Safety was a central focus of the analysis. The authors report that there were no vision-threatening intraoperative or postoperative complications in the series, which included eyes with prior failed glaucoma surgery.

Notably, the series included eyes with prior failed glaucoma surgery, a group that is often difficult to manage. The authors conclude that the findings suggest 240-degree goniotomy is promising both for primary congenital glaucoma generally and for patients who have already undergone other glaucoma procedures.

The study’s authors caution, through the design itself, that these results come from a small retrospective case series of 12 eyes with variable follow-up, so the success and complication rates should be interpreted as preliminary observations rather than definitive estimates of efficacy.

Subject of Research: Outcomes of 240-degree goniotomy surgery in primary congenital glaucoma

Article Title: Outcomes of 240-degree goniotomy in primary congenital glaucoma: a retrospective case series

Article References: Xie, B., Yang, Z., Wang, Z., Fang, Z., Song, Y., Lin, F., & Zhang, X. (2026). Outcomes of 240-degree goniotomy in primary congenital glaucoma: a retrospective case series. BMC Ophthalmology. https://doi.org/10.1186/s12886-026-05446-9

Image Credits: AI Generated

DOI: 10.1186/s12886-026-05446-9

Keywords: primary congenital glaucoma, goniotomy, intraocular pressure, glaucoma surgery, trabecular meshwork, case series, ophthalmology, BMC Ophthalmology, surgical outcomes, antiglaucoma medications, Outcomes, degree