Posters

Goniotomy with endocyclophotocoagulation (GoECP) to treat failed canaloplasty

Poster Details

First Author: D.Patel USA

Co Author(s):                        

Abstract Details

Purpose:

In patients who were previously treated with canaloplasty and did not achieve target IOP, option was given to perform goniotomy combined with ECP (GoECP) to avoid fistulizing the anterior chamber. Our goal was to achieve target intraocular pressure (IOP) and still maintain a closed ocular system.

Setting:

Mayo Clinic Arizona

Methods:

Chart analysis was conducted to identify patients who had undergone CP in previous 3 years. Fifteen patients, who were not at target IOP, underwent combined goniotomy & ECP and their outcomes were evaluated. The ECP treatment was applied to 360 degrees of the ciliary processes. Subsequently, the anterior chamber was filled with viscoelastic and trabecular meshwork (TM) visualized using gonio prism. The prolene stent that resided within the TM was grasped using forceps and pulled centrally. The stent was used to disrupt the TM. This effectively created a 360 degree goniotomy. Residual viscoelastic was removed and incisions closed.

Results:

Only 5 of the 15 patients met criteria for 3 mo follow up visit. All patients resulted in a lower IOP than at the pre-op visit. There was an average IOP reduction of 54% and reduction in at least one topical medication. No loss of visual acuity was detected when compared to pre-op visit.

Conclusions:

For patients who failed to achieve target IOP after canaloplasty, consideration should be given to performing ECP and goniotomy in this setting. Our series showed an average of 54% drop in IOP and avoided more complicated and riskier procedures like trabeculectomy.

Financial Disclosure:

None