Evan Kalin-Hajdu1, Karim Hammamji2, Sébastien Gagné2, Paul Harasymowycz2. 1. Department of Ophthalmology, University of Montreal, Montreal, Que.. Electronic address: evank123@gmail.com. 2. Department of Ophthalmology, University of Montreal, Montreal, Que.
Abstract
OBJECTIVE: To evaluate the safety and efficacy of circumferential viscodilation and tensioning of Schlemm's canal (canaloplasty) in the treatment of uveitic glaucoma (UG). DESIGN: Pilot, retrospective, noncomparative case series. PARTICIPANTS: Nineteen uveitic eyes of 15 patients with UG. METHODS: The main outcome measure was surgical success. Secondary outcome measures included intraocular pressure, usage of ocular hypotensive medication, visual acuity, and sight-threatening complications. Patients were included when UG could not be controlled despite maximum tolerated medical therapy. Exclusion criteria were peripheral anterior synechiae and previous glaucoma surgery. RESULTS: Mean follow-up time from canaloplasty was 2.6 ± 1.1 years. Mean intraocular pressure decreased from 30.4 ± 8.4 mm Hg preoperatively to 13.8 ± 5.0 mm Hg at last follow-up (p < 0.001). The mean number of ocular hypotensive medications decreased from 3.7 ± 0.8 preoperatively to 0.4 ± 1.0 at last follow-up (p < 0.001). At last follow-up, the complete success, qualified success, and failure rates were 73.7%, 10.5%, and 15.8%, respectively. No canaloplasty-related permanent sight-reducing complications occurred. Preoperative best corrected visual acuity decreased more than 1 Snellen line in 1 eye due to exacerbation of uveitis 18 months postoperatively. CONCLUSIONS: Canaloplasty appears to be a relatively safe and effective initial surgical intervention in UG.
OBJECTIVE: To evaluate the safety and efficacy of circumferential viscodilation and tensioning of Schlemm's canal (canaloplasty) in the treatment of uveitic glaucoma (UG). DESIGN: Pilot, retrospective, noncomparative case series. PARTICIPANTS: Nineteen uveitic eyes of 15patients with UG. METHODS: The main outcome measure was surgical success. Secondary outcome measures included intraocular pressure, usage of ocular hypotensive medication, visual acuity, and sight-threatening complications. Patients were included when UG could not be controlled despite maximum tolerated medical therapy. Exclusion criteria were peripheral anterior synechiae and previous glaucoma surgery. RESULTS: Mean follow-up time from canaloplasty was 2.6 ± 1.1 years. Mean intraocular pressure decreased from 30.4 ± 8.4 mm Hg preoperatively to 13.8 ± 5.0 mm Hg at last follow-up (p < 0.001). The mean number of ocular hypotensive medications decreased from 3.7 ± 0.8 preoperatively to 0.4 ± 1.0 at last follow-up (p < 0.001). At last follow-up, the complete success, qualified success, and failure rates were 73.7%, 10.5%, and 15.8%, respectively. No canaloplasty-related permanent sight-reducing complications occurred. Preoperative best corrected visual acuity decreased more than 1 Snellen line in 1 eye due to exacerbation of uveitis 18 months postoperatively. CONCLUSIONS: Canaloplasty appears to be a relatively safe and effective initial surgical intervention in UG.
Authors: Francisco J Muñoz-Negrete; Javier Moreno-Montañés; Paula Hernández-Martínez; Gema Rebolleda Journal: Biomed Res Int Date: 2015-10-19 Impact factor: 3.411