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Editors Selection IGR 9-4
Surgical Therapy: Canaloplasty for POAG in Africans
Comment by Robert Feldman on:
27121 Canaloplasty for primary open-angle glaucoma: Long-term outcome, Grieshaber MC; Pienaar A; Olivier J et al., British Journal of Ophthalmology, 2010; 94: 1478-1482
Grieshaber et al. (2008) report on a three-year follow up on a case series of canaloplasty as primary surgical intervention in a population of African primary open-angle glaucoma patients. Sixty black patients were prospectively followed after undergoing canaloplasty and eleven eyes (of 60) were lost to follow up. The mean baseline IOP was 45 ± 12 mmHg. At one and three years 15.4 and 13.2 mmHg, respectively. The study uses a primary outcome measure of IOP < 21 as success, but reported only complete success rate of 77% and qualified with medications of 81% at 36 months. The qualified success rate for IOP reaching 18 mmHg at 36 months was lower at 67.8%, and for 16 mmHg 47.2%. Complications were few. The success rate and the mean IOP suggest that there may be a significant number of eyes with single digit IOPs, but this information is not reported nor were any cases of hypotony reported. These data suggest that canaloplasty may be effective in lowering IOP in eyes with very high untreated IOP that do not require a low-target pressure.
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