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Abstract #107910 Published in IGR 23-4
Long-Term Efficacy and Safety of Modified Canaloplasty Versus Trabeculectomy in Open-Angle Glaucoma
Stingl JV; Wagner FM; Liebezeit S; Baumgartner R; Spät H; Schuster AK; Prokosch V; Grehn F; Hoffmann EMLife (Basel, Switzerland) 2023; 13:
BACKGROUND: To evaluate the long-term efficacy and safety of modified canaloplasty versus trabeculectomy in open-angle glaucoma. METHODS: In total, 210 subjects with open-angle glaucoma were included. 70 were treated with Mitomycin C-augmented modified canaloplasty with enhanced subconjunctival filtration and 140 with Mitomycin C-augmented trabeculectomy. Cases were matched 1:2 by sex and age. RESULTS: In canaloplasty and trabeculectomy groups, 61.4% and 57.9% of participants were female. Mean age was 60.0 ± 13.9 and 63.0 ± 12.2 years, median follow-up time was 4.6 [IQR 4.3, 5.05] years and 5.8 [IQR 5.4, 6.3]. Strict success was achieved in 20.0% and 56.4%, complete success in 24.3% and 66.4%, and qualified success in 34.3% and 73.6% (each < 0.001). Kaplan-Meier survival analysis showed a better survival probability for trabeculectomy than for canaloplasty ( < 0.001) and Cox regression analysis revealed an HR of 6.03 (95%-CI 3.66, 9.93, < 0.001) after canaloplasty. Trabeculectomy showed superiority in terms of IOP decrease (9.2 ± 7.9 mmHg vs. 13.7 ± 10.4 mmHg, = 0.002), use of AGM (50.0% vs. 10.7%, < 0.001), and the number of revision surgeries (41.4% vs. 21.4%, = 0.004). Occurrence of complications was similar in both groups (14.5% vs. 7.5%, = 0.19). CONCLUSIONS: Trabeculectomy showed superiority in efficacy and equality in safety compared to modified canaloplasty.
Department of Ophthalmology, University Medical Center of the Johannes Gutenberg-University Mainz, 55131 Mainz, Germany.
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