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    Combined Nasal Goniotomy/Temporal Trabeculotomy: A Novel Circumferential Angle Approach in PCG

    AAO 2022 Video Program
    Childhood Glaucoma, Congenital Glaucoma, Glaucoma, Pediatric Ophth/Strabismus, Surgical Management

    Circumferential angle surgery is the state of the art in treating primary congenital glaucoma (PCG), potentially replacing the classic goniotomy and trabeculotomy surgeries that treat localized portions of the angle. This video shows a novel combination for circumferential angle treatment in PCG. The new combination consists of goniotomy applied to the nasal angle and trabeculotomy applied to the temporal angle, hence the new term "nasal goniotomy/temporal trabeculotomy" (NGTT) surgery. The reported intraocular pressure reduction is 60% from pretreatment levels, without significant complications. NGTT spares the superior conjunctiva for future surgery, if needed. It also avoids the inherent difficulties associated with other 360-degree angle approaches safely and effectively.

    Financial Disclosures: Dr. Abdelrahman has no financial relationships to disclose.