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Abstract #45890 Published in IGR 13-2
Canaloplasty: Three-year results of circumferential viscodilation and tensioning of Schlemm canal using a microcatheter to treat open-angle glaucoma
Lewis RA; von Wolff K; Tetz M; Koerber N; Kearney JR; Shingleton BJ; Samuelson TWJournal of Cataract and Refractive Surgery 2011; 37: 682-690
Purpose: To report 3-year results of the safety and efficacy of canaloplasty, a procedure involving circumferential viscodilation and tensioning of the inner wall of Schlemm canal to treat open-angle glaucoma. Setting: Multicenter surgical sites. Design: Nonrandomized multicenter clinical trial. Methods: This study comprised adult open-angle glaucoma patients having canaloplasty or combined cataract-canaloplasty surgery. Qualifying preoperative intraocular pressures (IOPs) were at least 16 mm Hg with historical IOPs of at least 21 mm Hg. A flexible microcatheter was used to viscodilate the full circumference of the canal and to place a trabecular tensioning suture. Primary outcome measures included IOP, glaucoma medication use, and adverse events. Results: Three years postoperatively, all study eyes (n = 157) had a mean IOP of 15.2 mm Hg (plus or minus) 3.5 (SD) and mean glaucoma medication use of 0.8 (plus or minus) 0.9 compared with a baseline IOP of 23.8 (plus or minus) 5.0 mm Hg on 1.8 (plus or minus) 0.9 medications. Eyes with combined cataract-canaloplasty surgery had a mean IOP of 13.6 (plus or minus) 3.6 mm Hg on 0.3 (plus or minus) 0.5 medications compared with a baseline IOP of 23.5 (plus or minus) 5.2 mm Hg on 1.5 (plus or minus) 1.0 medications. Intraocular pressure and medication use results in all eyes were significantly decreased from baseline at every time point (P<.001). Late postoperative complications included cataract (12.7%), transient IOP elevation (6.4%), and partial suture extrusion through the trabecular meshwork (0.6%). Conclusion: Canaloplasty led to a significant and sustained IOP reduction in adult patients with open-angle glaucoma and had an excellent short- and long-term postoperative safety profile. Financial Disclosure: No author has a financial or proprietary interest in any material or method mentioned. Additional disclosures are found in the footnotes.
R. A. Lewis. Grutzmacher and Lewis, 1515 River Park Drive, Sacramento, CA 95815, United States. Email: rlewiseyemd@yahoo.com
Classification:
12.9 Trabeculotomy, goniotomy (Part of: 12 Surgical treatment)
