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Abstract #27121 Published in IGR 12-4
Canaloplasty for primary open-angle glaucoma: Long-term outcome
Grieshaber MC; Pienaar A; Olivier J; Stegmann RBritish Journal of Ophthalmology 2010; 94: 1478-1482
See also comment(s) by Robert Feldman •
Background/Aims: To study the safety and effectiveness of 360(degrees) viscodilation and tensioning of Schlemm canal (canaloplasty) in black African patients with primary open-angle glaucoma (POAG). Methods: Sixty randomly selected eyes of 60 consecutive patients with POAG were included in this prospective study. Canaloplasty comprised 360(degrees) catheterisation of Schlemm's canal by means of a flexible microcatheter with distension of the canal by a tensioning 10-0 polypropylene suture. Results: The mean preoperative intraocular pressure pressure (IOP) was 45.0(plus or minus)12.1 mmHg. The mean follow-up time was 30.6(plus or minus)8.4 months. The mean IOP at 12 months was 15.4(plus or minus)5.2 mmHg (n=54), at 24 months 16.3(plus or minus)4.2 mmHg (n=51) and at 36 months 13.3(plus or minus)1.7 mmHg (n=49). For IOP (less-than or equal to)21 mmHg, complete success rate was 77.5% and qualified success rate was 81.6% at 36 months. Cox regression analysis showed that preoperative IOP (HR=1.003, 95% CI=0.927 to 1.085; p=0.94), age (HR=1.000, CI=0.938 to 1.067; p=0.98) and sex (HR=3.005, CI=0.329 to 27.448; p=0.33) were all not significant predictors of IOP reduction to (less-than or equal to)21 mmHg. Complication rate was low (Descemet's detachment n=2, elevated IOP n=1, false passage of the catheter n=2). Conclusion: Canaloplasty produced a sustained longterm reduction of IOP in black Africans with POAG independent of preoperative IOP. As a bleb-independent procedure, canaloplasty may be a true alternative to classic filtering surgery, in particular in patients with enhanced wound healing and scar formation.
M. C. Grieshaber. Department of Ophthalmology, Medical University of Southern Africa, MEDUNSA, PO Box 66, Pretoria, South Africa. mgrieshaber@uhbs.ch
Classification:
12.8.3 Non-perforating (Part of: 12 Surgical treatment > 12.8 Filtering surgery)
