UBM Guided Site and Extent of Trabeculotomy in Pediatric Glaucoma

To study the value of using UBM to select the site and extent of trabeculotomy in pediatric glaucoma and its correlation with surgical outcomes.All Cases with pediatric glaucoma prepared for trabeculotomy including Primary congenital glaucoma and secondary glaucoma as : glaucoma following cataract surgery and traumatic glaucoma Methods

History taking:

• Family history of ocular pathologies or syndromes.
• Age at which the mother noticed ocular affection, time and type of intervention.
• Onset of IOP elevation, IOP lowering medications used and any previous surgical intervention for glaucoma.

Preoperative examination & assessment

• Examination under anaesthesia for state of the conjunctiva, conreal incision scars, corneal diameter, Haab's stria, broad limbus, anterior chamber depth, regularity and content, pupil shape, centration and response to mydriatics, IOL position and status in pseudophakic cases, IOP value, optic nerve cupping.
• A scan for axial length and central corneal thickness.
• B scan ultrasonography.
• UBM : full detailed anterior segment examination will be done including : trabecular iris angle width , presence of abnormal iris insertion , abnormal membranes , Schlemm canal studying and iris thickness. All these parameters will be recorded for all 4 quadrants to select the most appropriate site of trabeculotomy.