: to evaluate the surgical outcomes of goniotomy, trabeculotomy and combined trabeculotomy_trabeculectomy, as initial procedure in patients with primary congenital glaucoma (PCG) between 1994 and 2014 at the Labbafinejad Medical Center, Tehran, Iran

The medical records of patients with PCG who had undergone goniotomy, trabeculotomy or combined trabeculotomy_trabeculectomy with more than 12 months follow-up was retrospectively reviewed. The primary outcome measure was cumulative success rate which was defined as IOP 6-21 mmHg with or without medication and no serious complications, additional glaucoma surgery or lose of vision. The eyes were grouped into mild, moderate or severe PCG based on intraocular pressure, corneal diameter and clarity at the time of diagnosis. Associations between severity of PCG presentation and surgical outcome with consanguinity of parents were evaluated.

: A total of 215 eyes from 115 patients with the mean duration of follow up of 8±6.6 years were included. The difference in success rates among the three surgical procedures at 1, 2, 3, 4 and 5 years was not statistically significant. However Kaplan-meier survival analysis revealed that the success rates of combined trabeculotomy_trabeculectomy declined more slowly than trabeculotomy and goniotomy. PCG presented as mild, moderate and severe in 29%, 58.1% and 12.1% of the eyes. The rate of consanguinity was 65.2 % in parents of PCG patients but severity of the disease and surgical outcome were not statistically different in this group

In long-term follow-up success rate of combined trabeculotomy_trabeculectomy declined slower than goniotomy and trabeculotomy. Despite the high rate of consanguinity in parents of PCG patients, this did not adversely affect severity of PCG and outcomes of surgical treatment.