Posters

Two surgical approaches to Schlemm's canal for canaloplasty with expander: an intra-individual comparison

Poster Details

First Author: M.Grieshaber SWITZERLAND

Co Author(s):    A. Pienaar   R. Stegmann                 

Abstract Details

Purpose:

To compare the safety and efficacy of a modified scleral incision technique to the conventional scleral flap dissection for canaloplasty with Stegmann Canal Expander in patients with primary open-angle glaucoma (POAG).

Setting:

Department of Ophthalmology, Sefako Makgatho Health Sciences University (former Medical University of Southern Africa); South Africa.

Methods:

In a comparative case series, 32 eyes of 16 patients with primary open-angle glaucoma (POAG), access to Schlemm canal was created either by deep lamellar dissection (group 1) or by vertical radial cut (trench cut; group 2). Following viscodilation of the canal with a micro-cannula and sodium hyaluronidate, one Stegmann Canal Expander was implanted on either side of the ostia. The deep flap was excised in eyes of group 1. Superficial scleral flap (group 1) and vertical incision (group 2) was closed watertight. Primary outcome measures included intraocular pressure (IOP) and adverse events.

Results:

Preoperative IOP was 33.8 mmHg ± 7.4 (SD) in group 1 and 35.2 mmHg ± 7.7 (SD) in group 2 (p= 0.61), and postoperative IOP was 15.0 mmHg ± 2.0 (SD) in group 1 and 16.5 mmHg ± 3.2 (SD) at 12 months. IOP difference between preoperative and postoperative values was comparable (17.9 mmHg ± 10.3, group 1; 17.7 mmHg ± 9.7, group 2; p= 0.87). There was a significant effect for type of surgery adjusted for preoperative IOP, cup-to-disc ratio, eye-side, and follow-up (p less than 0.01). Rare complications were Descemet detachment (1) and microhyphema (1).

Conclusions:

In this intra-individual comparative study on canaloplasty with the Stegmann Canal Expander, IOP reduction was substantial in both groups and slightly greater in the group with deep scleral flap excision suggesting that intrascleral lake may contribute to an additional IOP reduction.

Financial Disclosure:

research is funded, fully or partially, by a competing company