Efficacy of bent angle needle goniectomy as a primary and redo surgery for management of pediatric glaucoma

Helal, Hend Gouda; Hamed, Abdelmoneim M; Salem, Tamer I; Awwad, Mohamed A

doi:10.21608/bmfj.2025.371367.2354

Efficacy of bent angle needle goniectomy as a primary and redo surgery for management of pediatric glaucoma

Articles in Press

Document Type : Original Article

Authors

¹ Ophthalmology department ,Faculty of medicine , Benha University .

² Department of ophthalmology, Faculty of Medicine, Benha University.

³ Department of Ophthalmology, Faculty of Medicine, Benha University, Egypt.

⁴ Department of Opthalmology , Benha University Hospital , Benha , Qualubia , Egypt

10.21608/bmfj.2025.371367.2354

Abstract

Background: To evaluate the effectiveness of bent angle needle goniectomy (BANG) in treating congenital glaucoma, whether as a primary or secondary treatment following previous failure surgeries. Methods: This study focused on paediatric glaucoma patients who underwent BANG at the Benha glaucoma unit between 2020 and 2023. Patients were divided into two groups: Group A included patients who underwent BANG as a primary procedure, while Group B comprised patients who had BANG as a secondary procedure. Group A was divided into neonatal (A1) and infantile (A2) categories. Group B was subdivided into the post-trabeculotomy group (B1) and the post-trabeculectomy group (B2). Success was determined by an intraocular pressure (IOP) of 20 mmHg or less, with or without medications. Results: Forty-eight eyes of thirty-nine children were examined. Both groups experienced a significant reduction in intraocular pressure (IOP) after BANG. At the end of one year of follow-up, groups A and B showed reductions in IOP of 52.4% and 50.1% respectively. Success rates for primary and redo surgeries were 75% and 62.5% respectively. The success rate was higher in group A2 (81.25%) compared to group A1 (62.5%). Conversely, post-trabeculotomy was more successful (64.28%) than post-trabeculectomy (60%). The failure rate was higher in eyes with higher baseline IOP, longer axial length, larger corneal diameter and positive consanguinity. There were no significant intraoperative or postoperative complications. Conclusion: BANG is an effective surgery for managing paediatric glaucoma. It can also be used as a secondary surgery following unsuccessful previous procedures.

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