Posters

Three generations of stainless steel spiral Schlemm's canal expanders in management of open-angle glaucoma: comparative results through two years

Poster Details

First Author: V.Kumar RUSSIA

Co Author(s):    G. Dushina   M. Frolov   A. Shradqa   A. Bezzabotnov           

Abstract Details

Purpose:

To compare results of Schlemm’s canal (SC) dilation using Kumar’s different stainless steel spiral Schlemm’s canal expanders (SCEs) in decreasing intraocular pressure (IOP) and hypotensive medication(s) use in patients suffering from open angle glaucoma (OAG).

Setting:

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

Methods:

Medical records of 99 patients having undergone implantation of Kumar's different SCEs between October,2012 and April,2016 and follow-up >2 years were retrospectively evaluated. Expanders were made from AISI 316L wire and main characteristics were: SCE-I: length (L)-5-6mm, wire thickness (WT) 05mm, outer diameter (OD)3mm, inner diameter (ID)2mm, weight452mg; SCE-II: L-3-4mm, WT04mm, OD2mm, ID12mm, weight238mg: SCE-III: L-4-5mm, WT05mm, OD25mm, ID15mm, weight318mg. SCEs were implanted into SC ab externo. Outcome measures: IOP change, number of hypotensive medications, complications. Success rates were evaluated using World Glaucoma Association's guidelines. A paired t-test was used for analysis. Results were significant when p <.05.

Results:

At 24 months, in SCE-I group, IOP decreased by 25.4% (from 30.2±4.9mmHg to 22.5+/-3.7), medication use reduced from 3.0±.7 to 1.1±1.2, complete success (CS) achieved in 50% cases and failure was in 6% cases; in SCE-II, IOP decreased by 37.2% (from 30.4±5.5mmHg to 19.1±6), medication use reduced from 2.5±.8 to 1.0±1.1, CS achieved in 57.3% cases and failure was in 14.6% cases; in SCE-III, IOP decreased by 25.3% (from 28.4±4.8mmHg to 21.2±2.5), medication use reduced from 2.5±.9 to 1±1, CS achieved in 61.5% cases and failure was in 7.7% cases. P(between groups) for IOP decrease and medication use was >.05.

Conclusions:

In long terms ab externo implantation of Kumar’s different SCEs was safe and effective in decreasing IOP from the baseline and hypotensive medication use in patients suffering from OAG. A customized use of different SCEs according to SC diameter of patient could be more beneficial if SC diameter is made known prior to surgery.

Financial Disclosure:

None