Canaloplasty - Efficacy and Safety in an 18-Month Follow Up Period, and Analysis of Outcomes in Primary Open Angle Glaucoma Pigmentary Glaucoma and Pseudoexfoliative Glaucoma

• Published in: Seminars in ophthalmology 2022-07, Vol.37 (5), p.602-610
• Main Authors: Łazicka - Gałecka, Monika, Kamińska, Anna, Gałecki, Tomasz, Guszkowska, Maria, Dziedziak, Jacek, Szaflik, Jerzy, Szaflik, Jacek P.
• Format: Article
• Language: English
• Subjects: Canaloplasty; Non-penetrating glaucoma surgery; Open-angle glaucoma; Schlemm's canal surgery
• ISSN: 0882-0538; 1744-5205
• DOI: 10.1080/08820538.2022.2034897

Open-angle glaucoma (OAG), accounting for 90% of all glaucoma cases, is a progressive optic nerve neuropathy. It may lead to irreversible loss of visual field and complete blindness. When conservative treatment becomes insufficient to stop OAG progression, a surgical intervention is considered. Currently, canaloplasty procedure is being introduced instead of conventional trabeculectomy for invasive OAG treatment. The aim of the study is to asses safety and efficacy of canaloplasty. This prospective study included 67 eyes that received 360° canaloplasty with placement of a tensioning suture. Primary OAG (n = 35), secondary OAG in pseudoexfoliative syndrome (n = 13), and pigmentary glaucoma (n = 19) patients were included. Control check-ups were conducted pre-operatively and in a 18-month follow-up time. Study endpoints involved reduction in IOP values and in the number of glaucoma medications after the intervention. The intervention led to a significant 38% reduction in IOP value from the preoperative baseline to 18 months after the intervention. The number of medications decreased significantly by 89%. At 18 months postoperative, 79% eyes did not require any glaucoma medications. The incidence of complications after canaloplasty was low, and none of the adverse effects were vision threatening. A surgically-induced astigmatism was the most frequent complication. Pigmentary glaucoma patients were the most beneficial subgroup, with 50% reduction in IOP, the highest success rate, and 98% reduction in the number of medications used. This study proved that canaloplasty is an efficient and safe procedure in OAG eyes.