Combined ab externo Schlemm's canal surgery and phacoemulsification with intraocular lens implantation in management of open-angle glaucoma in cataract patients

Session Details

Session Title: Combined Cataract Surgery Techniques. Surgical Devices

Session Date/Time: Saturday 05/09/2015 | 08:30-10:30

Paper Time: 08:30

Venue: Main Auditorium

First Author: : G.Dushina RUSSIA

Co Author(s): :    V. Kumar   M. Frolov   E. Bozhok              

Abstract Details

Purpose:

To evaluate the effectiveness of segmental Schlemm's canal (SC) distension using Kumar's 2nd generation Schlemm's canal expander (SCE) in decreasing intraocular pressure (IOP) in cataract patients suffering from open angle glaucoma (OAG).

Setting:

Ophthalmic unit of Skhodnya city hospital, Moscow province; People's friendship university of Russia Medical Institute Department of Ophthalmology, Moscow, Russian Federation.

Methods:

Results of Kumar's 2nd generation SCE implantation into a segment of SC in 19 patients during combined surgery for cataract and OAG were retrospectively analyzed. The 2.5-3.0 mm long SCE device, made from 0.04mm thick medical grade stainless steel wire, having inner lumen diameter of .12mm and outer - .2mm was implanted into SC ab externo after completion of cataract surgery. Outcome measures were IOP change, number of glaucoma medications pre- and postoperatively and complications. Success rates were evaluated using World Glaucoma Association guidelines. A paired t-test was used for analysis. Results were significant when p less than .05.

Results:

Mean preoperative IOP was 23.1+/–6.1mmHg and mean number of medications - 2.6+/–1.0. At 6 and 12 months mean IOP reduced by 41.1+/–27.9 and 45.3+/–15.7% and was 11.8+/–2.2 (n=15; p=.0000007) and 12.5+/–2.0mmHg (n=12; p=.000001); use of medications reduced to .7+/–.9 (p=.0000001) and 1.1+/–1.1 (p=.0008) and complete success was achieved in 47 (7/15) and 33% (4/12) cases and partial – in 40 (6/15) and 50% (6/12) cases respectively. Intraoperatively, microperforation occurred in 5 cases (26%) and posterior capsule rupture - in 1 case (5%). Postoperatively, 2 cases (10%) required YAG laser trabeculopuncture to control IOP.

Conclusions:

Results of combined surgery – phacoemulsification with intraocular lens implantation and SCE implantation in surgical management of OAG in cataract patients show significant reduction in IOP from the baseline and in hypotensive medication(s) use.

Financial Interest:

NONE