Posters

Phacocanaloplasty: advanced study

Poster Details

First Author: B.Babayeva AZERBAIJAN

Co Author(s):    E. Kasimov   L. Bilandarli   J. Gasanov              

Abstract Details

Purpose:

Pseudoexfoliative syndrome (PES) is pathology of extracellular matrix, accompanied by excessive production and accumulation of pathological extracellular material in intra – and extraocular tissues. Around 70 million people in the world have been suffering by PES, while 33% of them had glaucoma. Pseudoexfoliation glaucoma (PEG) causes blindness 2 times more often than primary open-angle glaucoma. Almost 70% of patients diagnosted by PEG combined with cataract. The effectiveness of fistulizing operations in patients with PEG is significantly reduced. The purpose was to study the anatomical and topographic relationships of the anterior segment of the eye with PEG before and after phacocanaloplasty.

Setting:

National Center of Ophthalmology named after academician Z. Aliyeva, (Azerbaijan, Baku).

Methods:

A total of 8 patients (8 eyes), 3 males and 5 females with advanced PEG accompanied by cataract were enrolled in this study. A mean age was 68,21±2,35 years. Average preoperative IOP was 29,6±4,3 mm Hg. All patients underwent phacocanaloplasty guided by Glaucolight elastic microcatheter (DORC, The Netherlands) and further phacoemulsification with IOL implantation. We carried out the study of anatomical and topographic relationships of the anterior segment of the eye before and in 1 and 4 weeks after surgery using ultrasound biomicroscopy (Ellex, Australia). All parameters were analyzed by two meridians (6´ and 12´o’clock positions).

Results:

Preoperative study revealed the pronounced changes in zonular fibres (stretching, thickening, unevenness (0,32-0,75 mm), partial leasing), changes in the iris profile, asymmetry of ciliary zone of the iris and ciliary body, unevenness of anterior and posterior chambers depth (difference of maxPCD in various segments up to 0,37 mm), shortening of “trabecula-iris”(250μm) and “trabecula-ciliary processes ”distances (0,13 and 0,59 mm respectively). Postoperative changes: difference of maxPCD – 0,32 and 0,25mm respectevely, “trabecula-iris” – 0,15 and 0,17mm, “trabecula-ciliary processes ”- 0,64 and 0,71mm, expansion of Schlemm’s canal- 434,3x459,0μm and 422,5x449,2μm with visualization of strong reflex of suture within the canal.

Conclusions:

Significant restoration of anatomical and topographic relationships of the eye’s anterior segment and expanding of the Schlemm’s canal contribute the normalization of the physiological outflow of the intraocular fluid. In this way, phacocanaloplasty is non-penetrative antiglaucomatous surgery preferable as the first choice surgery for patients suffered by PEG associated with cataract.

Financial Disclosure:

None