Outcomes of canaloplasty for glaucoma: 2 year results

Session Details

Session Title: Glaucoma I

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

Paper Time: 09:36

Venue: Room 10

First Author: : P.Santorum ITALY

Co Author(s): :    M. Simonazzi   E. Bertelli                 

Abstract Details

Purpose:

To evaluate the 2-year results of canaloplasty to treat elevated intraocular pressure (IOP) in eyes with different types of glaucoma.

Setting:

“San Maurizio” Regional Hospital, Bolzano, Italy

Methods:

Forty-nine glaucomatous eyes that underwent canaloplasty since 2010 were included in this retrospective study. Canaloplasty procedures included: a. Dissection of a superficial scleral flap; b. Removal of a deep scleral flap to expose Schlemm's canal and a Descemetic window; c. Viscodilation of the Schlemm's canal with a dedicated flexible microcatheter; d. Tensioning of the inner wall of the Schlemm's canal by means of two 10-0 polypropylene circumferential sutures. e. Tight closure of the superficial scleral flap with 10-0 absorbable sutures. At every postoperative visit IOP, glaucoma medication use, and complications were recorded.

Results:

Canaloplasty was completed successfully in 37 (77%) eyes. Nine (18%) eyes required conversion to viscocanalostomy, and 3 (6%) eyes to trabeculectomy. Respectively 1 and 2 years after surgery mean IOP was 13.2±3.0 and 13.7±2.5 with 0.7 and 0.6 medications, compared with a baseline IOP of 24.9±5.7 with 2.7 medications. Success (IOP ≤17mmHg) was achieved in 78% and 68% of eyes respectively 1 and 2 years after surgery. Failure rate was higher in eyes that remained phakic after canaloplasty (38% vs 5% p=0.03). Complications included hyphema in 9 (18%) eyes and anterior chamber penetration in 5 (10%) eyes, but not hypotony.

Conclusions:

Canaloplasty is both safe and effective in lowering intraocular pressure. The outcomes of IOP control after canaloplasty do not differ substantially from those reported after trabeculectomy. Phakic canaloplasty procedures have a worse outcome than pseudophakic canaloplasty or combined canaloplasty-phacoemulsification procedures. Complications of canaloplasty compare favourably with those reported after trabeculectomy.

Financial Interest:

NONE