Ab externo Schlemm's canal surgery in management of open-angle glaucoma

Session Details

Session Title: Glaucoma I

Session Date/Time: Monday 07/09/2015 | 08:00-10:30

Paper Time: 09:52

Venue: Room 10

First Author: : V.Kumar RUSSIA

Co Author(s): :    M. Frolov   G. Dushina   E. Bozhok              

Abstract Details

Purpose:

To evaluate the effectiveness of segmental Schlemm's canal (SC) distension using Kumar's 2nd generation stainless steel spiral Schlemm's canal expander (SCE) in decreasing intraocular pressure (IOP) in patients with 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 13 patients with OAG were analyzed retrospectively. The 2.5-3.0 mm long SCE, made from 0.04mm thick medical grade stainless steel wire, having inner lumen diameter .12mm, outer - .2mm was implanted into SC ab externo after viscocanalostomy. SC was exposed without creating a window in Descemete's membrane. Outcome measures: 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 26.0+/–5.4mmHg and mean number of medications - 2.3+/–.8. At 6 and 12 months mean IOP reduced by 51.3+/–10.2 and 44.5+/–12.8% and was 12.3+/–0.9 (n=12; p=.0000006) and 14.1+/–3.1mmHg (n=12; p=.000001); use of medications reduced to 0.5+/–0.7 (p=.000002) and 0.7+/–1.0 (p=.0001). Complete success was achieved in 58% (7/12) cases and partial – in 42% (5/12) cases at 6 and 12 months respectively. Microperforation of trabecular meshwork occurred in 2 cases. Postoperatively, 2 cases (17%) after 3 months and 1 case (8%) after 1 year required YAG laser trabeculopuncture to control IOP.

Conclusions:

Results of SCE insertion in surgical management of OAG show significant reduction in IOP from the baseline and in hypotensive medication(s) use.

Financial Interest:

NONE