Canaloplasty: circumferential viscodilation and tensioning of Schlemm canal using a flexible microcatheter for the treatment of open-angle glaucoma in adults: two-year interim clinical study results

J Cataract Refract Surg. 2009 May;35(5):814-24. doi: 10.1016/j.jcrs.2009.01.010.

Abstract

Purpose: To evaluate 2-year postsurgical safety and efficacy of canaloplasty (circumferential viscodilation and tensioning of the inner wall of Schlemm canal) to treat open-angle glaucoma (OAG).

Setting: Multicenter surgical sites.

Methods: This international prospective study comprised adult OAG patients having glaucoma surgery or combined glaucoma-cataract surgery. Qualifying preoperative intraocular pressure (IOP) was at least 16 mm Hg and historical IOP, at least 21 mm Hg. The full circumference of the canal was viscodilated and a trabecular tensioning suture placed with a microcatheter. Primary outcome measures included IOP and glaucoma medication use.

Results: At 24 months, all 127 eyes (127 patients) had a mean IOP of 16.0 mm Hg +/- 4.2 (SD) and mean glaucoma medication use of 0.5 +/- 0.8 (baseline values 23.6 +/- 4.8 mm Hg and 1.9 +/- 0.8 medications). Eyes with canaloplasty alone had a mean IOP of 16.3 +/- 3.7 mm Hg and 0.6 +/- 0.8 medications (baseline values 23.2 +/- 4.0 mm Hg and 2.0 +/- 0.8 medications). Eyes with combined glaucoma-cataract surgery had a mean IOP of 13.4 +/- 4.0 mm Hg and 0.2 +/- 0.4 medications (baseline values 23.1 +/- 5.5 mm Hg and 1.7 +/- 1.0 medications). The IOP and medication use results at all time points were statistically significant versus baseline (P <.001). The late postoperative follow-up identified 3 patients with elevated IOP. No other serious ocular or nonocular complications were reported.

Conclusion: Canaloplasty was safe and effective in reducing IOP in adult patients with OAG.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Anterior Eye Segment / diagnostic imaging
  • Anterior Eye Segment / surgery*
  • Catheterization
  • Female
  • Filtering Surgery / methods*
  • Glaucoma, Open-Angle / surgery*
  • Gonioscopy
  • Humans
  • Hyaluronic Acid / administration & dosage*
  • Intraocular Pressure
  • Male
  • Microscopy, Acoustic
  • Middle Aged
  • Polypropylenes
  • Prospective Studies
  • Suture Techniques*
  • Sutures
  • Treatment Outcome
  • Viscosupplements / administration & dosage*
  • Visual Acuity

Substances

  • Polypropylenes
  • Viscosupplements
  • Hyaluronic Acid