Comparative study of the segmental dilation of Schlemm's canal with Kumar’s 3rd generation Schlemm’s canal expander, combined with phacoemulsification and without

Session Details

Session Title: Cataract Surgery & Glaucoma

Session Date/Time: Sunday 23/09/2018 | 14:00-16:00

Paper Time: 14:46

Venue: Room A3, Podium 1

First Author: : G.Dushina RUSSIA

Co Author(s): :    V. Kumar   M. Frolov   A. S. Shradqa   A. Bezzabotnov           

Abstract Details

Purpose:

To evaluate the safety and efficiency of the segmental dilation of Schlemm's canal (SC) using Kumar’s 3nd generation Schlemm’s canal expander (SCE) in decreasing intraocular pressure (IOP) suffering from open angle glaucoma (OAG) combined with phacoemulsification and without.

Setting:

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

Methods:

Medical records of 39 patients suffering from OAG. Between May, 2014 and May, 2016 retrospectively evaluated: 28 cases with coexisting pathology a combined two site procedure – phacoemulsification and SCE implantation performed; and 11 cases only segmental dilation of SC performed. The 5 mm long spiral device made from 0.05mm thick medical grade stainless steel wire (inner lumen diameter 0.15mm, outer 0.25mm) was implanted into SC ab-externo. Outcome measures: IOP change, number of glaucoma medications and complications. Success rates were evaluated using WGA's guidelines. A paired t-test was used for analysis. Results were significant when p less than 0.05.

Results:

In two years the complete success was achieved after segmental dilation of S in 7 cases, 63%; the partial success was observed in 3 cases, 27,3%; reoperation has been needed in 1 case. After combined surgery segmental dilation of SC and phacoemulsification the complete success was achieved in 17 cases, 60,7%; the partial success in 9 cases, 32,1%; failure in 2 cases, 7,1%, in these cases the subsequent surgery was needed. Intra-operatively micro-perforation of trabecular meshwork occurred in 9 cases. Gonioscopicaly the devices's one end was lying in the anterior chamber angle without contact with intraocular structures in these cases.

Conclusions:

Two year results of SCE insertion in surgical management of OAG combined with phacoemulsification or without show significant reduction in IOP from the baseline and in hypotensive medications use. Hence it can be concluded that implantation of SCE with phacoemulsification or without is a safe and effective procedure in reducing IOP.

Financial Disclosure:

gains financially from product or procedure presented

Financial Disclosure:

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