First Author: C.Mehta INDIA
Co Author(s): K. Mehta
Purpose:
to demonstrate that at one year canaloplasty with subconjuctival mitomycin c and phaco with foldable lens implantation is a successful procedure in terms of IOP reduction in Primary open angle glaucoma patients.
Setting:
international eye centre ,mumbai,india
Methods:
Over a period of 6 months patients with primary open angle glaucoma were selected for surgery and operated based on the following criteria. IOP over 25 mmHg on maximally tolerated medication or intolerance to or non compliance with glaucoma medication with IOP over 25mmHG.All these patients also had cataract that significantly obstruction vision to warrant removal.
First mitomycin c was applied as 0.05% for 2 minutes subconjuctivally .Next cataract phaco surgery was performed by the same surgeon though a clear corneal separate site incision.A 10.0 prolene suture was passed 360 degrees through schlemms canal using a canaloplasty technique and a fibreoptic device with a extremely thin fibre with a red beacon at its tip,and then tied over the sclerectomy area.The superficial flap was then loosely sutured back and conjunctiva reposed using 8.0 vicryl sutures.
IOP was measured with applanation tonometry at day 2 ,day 30,day 180,one year.
Results:
On day 2 the IOP ranged between 2 and 7 for all eyes .On day 30 the IOP ranged between 9 and 14 for all eyes.By day 180 the range was 12 to 15.Between one month and 6 months 5 eyes were deemed to be " failures" (IOP over 20 mmHg without topical glaucoma medication).These cases were " revised" internally by trabecular membrane rupture.
By one year 3 eyes of 4 patients were lost to follow up.Fourteen eyes had pressures between 12 and 17 without any additional topical medication
Conclusions:
Canaloplasty with mitomycin c and phacoemulsification with foldable iol implantation is effective and safe as a means of controlling IOP in eyes with POAG and cataract FINANCIAL DISCLOSURE?: No
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