Ab-interno 360-degree viscocanalostomy using a single-handed microcatheter

Session Details

Session Title: Glaucoma & Posterior Segment

Session Date/Time: Monday 24/09/2018 | 08:00-10:30

Paper Time: 10:12

Venue: Room A3, Podium 1

First Author: : M.Grieshaber SWITZERLAND

Co Author(s): :    A. Schoetzau   S. Orgul                 

Abstract Details

Purpose:

To investigate safety and intraocular pressure (IOP) of ab interno viscocanalostomy using a single-handed microcatheter and viscoelastic-driven surgical system (Visco360) in Europeans with primary open-angle glaucoma (POAG).

Setting:

Non-comparative study of 44 consecutive patients with early to moderate POAG underwent stand-alone ab interno viscocanalostomy (group 1) or combined with cataract surgery (group 2) with a follow-up time of at least 6 months. Indications for glaucoma surgery were intolerance to eye drops, and /or presence of cataract with POAG.

Methods:

Through clear cornea incision, the visco360 system is introduced into the anterior chamber and the outer wall of Schlemm canal is pierced with the build- in cannula. The microcatheter is gently advanced in the canal to 180 degree under gonioscopic view, and a determined volume of viscoelastic fluid is automatically injected into the canal lumen upon retraction of the microcatheter back into the cannula. The procedure is done for both canal semicircles. In combined surgery, phacoemulsification and intraocular lens implantation was performed before ab interno viscocanalostomy.

Results:

Preoperative IOP was 17.6 mmHg ± 2.64 (SD) in group 1 and 20.0 mmHg ± 3.24 (SD) in group 2 (p= 0.01). Postoperative IOP was 16.5 mmHg ± 1.1 (SD) in group 1 and 14.0 mmHg ± 3.3 (SD) at 12 months (p=0.024). Pressures equal or less than 16 mmHg without medications were 60.7% in group 1, and 81.5% in group 2 at 12 months. Medications before surgery were 2.1 ± 0.9 and after surgery 0.06 ± 0.25 (p less than 0.001). Minor complications were microhyphema (12 eyes) and transient elevated IOP (5 eyes), myopic shift (2 eyes).

Conclusions:

In this preliminary study period of one year, ab interno viscocanalostomy using the visco360 device was safe and resulted in a target IOP necessary for managing early to moderate POAG while lowered markedly the number, whether it was performed as stand-alone procedure or combined with cataract surgery.

Financial Disclosure:

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