Abstract:  Objective To evaluate the long-term effectiveness and safety of ab externo microcatheter-assisted trabeculotomy(MAT) for the surgical management of primary congential glaucoma(PCG). Design Retrospective case series. Participants Consecutive 65 patients (85 eyes) with PCG who underwent ab externo MAT between February 2012 and December 2016 by a single surgeon in Beijing Tongren Eye Center. Methods Patients were followed before and 3, 6, 9 months, 1, 2, 3, 4, 5, 6 years after surgery. Intraocular pressure (IOP) and usage of anti-glaucoma medication were compared between before surgery and last visit after surgery. Surgical success was defined as a postoperative IOP of ≤21 mmHg with (qualified success) or without (complete success) the use of anti-glaucoma medication. Main Outcome Measures IOP, number of anti-glaucoma medication, surgical complications, and further glaucoma surgery performed.  Results Mean follow-up time was 46.3±9.9 months (range: 36-72 months). Post-operative IOP and number of glaucoma drops (15.6 ± 7.9 mmHg, 0.4 ± 1.0 medications) was significantly less than the pre-operative values (32.5±6.4 mmHg, 2.8±0.6 medications; all P<0.001). The 1-, 3-, and 5-year cumulative probabilities of complete success was 90.7%, 86.0%, and 68.8%, and those of qualified success was 90.7%, 88.3%, and 76.9%, respectively. Five-year cumulative probabilities of complete success for eyes with previous surgeries (60.2%) was lower than eyes without previous surgeries (94.3%, P=0.04). Conclusion Ab externo MAT has long-term effectiveness and safety in the management of PCG. Previous anti-glaucoma surgery affects the success rate of Ab externo MAT.  (Ophthalmol CHN, 2020, 29: 15-19)

Key words: ab externo microcatheter-assisted trabeculotomy, primary congenital glaucoma