Catheter-independent suture probe canaloplasty with suprachoroidal drainage

Haus, Arno; Szurman, Peter; Seuthe, Anna‐Maria

doi:10.1007/s00417-018-4182-7

Cited by 8 publications

(9 citation statements)

References 16 publications

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“…However, twisted 6/0 sutures possessed a smooth loop tip and similar body diameter to iTrack™. It also had a deformable loop tip helping to advance in the SC, which was better than iTrack™ and avoided false pathing[ 10 ]. Material characterizations indicate that the polypropylene suture has similar physical and chemical properties to iTrack™, although some differences exist such as without illuminated tip.…”

Section: Discussionmentioning

confidence: 99%

“…Afterward, a few doctors applied sutures in canaloplasty instead of a dedicated microcatheter. Haus initiated the twisted 6/0 suture for circumferential probing and reported a probing rate of 71.6% [ 10 ]. Our previous study reported a cannulation rate of 88.7% by 5/0 suture in primary congenital glaucoma.…”

Section: Discussionmentioning

confidence: 99%

“…Beck first applied a 6/0 polypropylene suture in circumferential cannulation in trabeculotomy for primary congenital glaucoma (PCG) in 1995 [ 9 ]. In 2019, Haus and Kodomskoi proposed polypropylene sutures instead of the microcatheter for circumferential probing in canaloplasty [ 10 , 11 ].…”

Section: Introductionmentioning

confidence: 99%

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Modified suture-assisted canaloplasty in Asians with primary open-angle glaucoma: a prospective study with 12-month follow-up

Liang

Sun

et al. 2022

BMC Ophthalmol

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Background To evaluate the efficacy and safety of modified suture-assisted canaloplasty in Asians with primary open-angle glaucoma (POAG). Methods A prospective, consecutive cases study, evaluating a modified canaloplasty by twisted 6/0 suture was performed on Asian POAG patients. Three modifications of this canaloplasty included opening the Schlemm’s canal by viscocanalostomy, circumferential probing by a twisted 6/0 suture and loose suture of the superficial scleral flap. The twisted 6/0 suture was selected as a prober based on characteristical analysis of size and contact measurement as well as chemical composition conducted among 5/0, twisted 6/0 polypropylene sutures and the microcatheter. Success criteria were defined as intraocular pressure (IOP) ≤ 21 mmHg, 18 mmHg, 15 mmHg, and ≥ 20% reduction without (complete success) or with medications (qualified success). Efficacy was assessed by the success rate of circumferential catheterization, IOP values, the success rate of the surgery, the number of IOP-lowering medications, best-corrected vision acuity (BCVA), cup-to-disc ratio (C/D), and mean deviation (MD). Safety was evaluated by adverse events. Results Forty eyes from 40 consecutive patients were included with a mean follow-up of 14.8 ± 3.0 months. Circumferential catheterization was successfully conducted in 36 eyes (90%). Mean IOP decreased from 26.2 ± 6.9 mmHg to 14.5 ± 2.7 mmHg at 12 months postoperatively. While medication numbers were reduced from 3.2 ± 0.6 to 0.5 ± 0.8 at month 12 (both p < 0.001). Qualified success rate was 97.2% [95% confidence interval (CI) 0.92–1.03], 86.1% (95% CI 0.74–0.98) and 66.7% (95% CI 0.51–0.83) at 12 months with three criteria. BCVA, C/D and MD did not show progression at 1-year follow-up (p > 0.05). Age, baseline IOP, and spherical equivalent negatively influenced the success rate significantly (all p < 0.05). Adverse events included hyphema (30.6%), IOP spike > 25 mmHg (8.3%), and peripheral synechia to the trabecular-Descemet’s membrane (2.7%). Conclusion Twisted 6/0 suture can be an ideal material for cannulation. Modified suture-assisted canaloplasty is an effective, safe alternative with a cost-efficient feature for patients with POAG, especially in developing countries. Trial registration This trial was registered in the Chinese Clinical Trial Registry (ChiCTR1900028618, 29/12/2019).

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Modified suture-assisted canaloplasty in Asians with primary open-angle glaucoma: a prospective study with 12-month follow-up

Liang

Sun

et al. 2022

BMC Ophthalmol

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“…Regarding early postoperative complications in both groups, the most commonly seen were hyphema, cheese-wiring, and transient IOP rising. Recently, a similar study from Haus et al [20] introduced a novel technique of suture probe canaloplasty with suprachoroidal drainage as a catheter-independent and ▶ Fig. 2 Box and whisker plot of the mean IOP reduction between Group A and Group B (two-way ANOVA, p < 0.001).…”

Section: Discussionmentioning

confidence: 99%

The Efficacy of Ab Externo Canaloplasty by Using a Nonabsorbable Suture and No Viscoelastics; IOP Results, Intraoperative and Early Complication Rates within 6-Month Follow-Up Period

Vastardis

Fili

Perdikakis

et al. 2021

Klin Monbl Augenheilkd

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Background To report the efficacy of ab externo canaloplasty by exclusively using only a nonabsorbable suture as a standalone operation or combined with phacoemulsification in terms of mean intraocular pressure (IOP), medication reduction, and intra- and postoperative complication rates as well as additional glaucoma surgery. Patients and Methods Forty-eight patients with primary open-angle glaucoma (POAG) and 50 eyes were divided into two groups according to the operation performed (Group A canaloplasty, n = 34 and Group B canaloplasty combined with phaco, n = 16), respectively. The success criteria were evaluated between three IOP ranges: a) IOP ≤ 16 mmHg, b) ≤ 18 mmHg, and c) ≤ 21 mmHg. Complete success was considered the percentage of eyes reaching these goals with no medication and qualified success with or without medication. Groups A and B were compared with the Kaplan-Meier test. Mean IOP and medication reduction as well as additional glaucoma surgery were also evaluated. The follow-up time was 6 months. Statistical importance was given at p < 0.05. Results Fail rate and intraoperative conversion of canaloplasty to other surgery (trabeculotomy due to extensive cheese-wiring) accounted for 12% (6 eyes), while a mandatory usage of the iTrack 250A microcatheter to successfully overcome intracanalicular bridging of the Schlemmʼs canal accounted for 20% (10 eyes). The most common early postoperative complications in both groups were hyphema, cheese wiring, and transient IOP rising. The mean IOP in Group A reduced from 23.67 ± 6.06 mmHg to 13.35 ± 4.23 mmHg and in Group B, it reduced from 23.55 ± 6.19 mmHg to 12.75 ± 1.5 mmHg at 6 months (p < 0.001). Group Aʼs absolute success rates accounted for a) 44%, b) 47.1%, and c) 52.9% in comparison to Group B [a) 50%, b) 50%, and c) 56.3%] at 6 months (p < 0.05). Qualified success with or without medication showed no statistical differences between the groups. The mean medication reduction was significantly lower (p < 0.001) in both groups (Group A from baseline 3.2 ± 1.23 to 0.95 ± 1.35 and Group B from 3.12 ± 0.88 to 1.12 ± 0.75 at 6 months, respectively). Five eyes (10%) required additional glaucoma surgery. Conclusions Ab externo canaloplasty by exclusively using only a nonabsorbable suture as a standalone operation or combined with phacoemulsification seems to lower the mean IOP and medication sufficiently. However, they pose a greater surgical challenge and intraoperative complication rate. Additional glaucoma surgery or medication following both procedures may be necessary to achieve an optimal target IOP.

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“…78 Haus et al performed canaloplasty with suprachoroidal drainage using a standard 6/0 polypropylene suture, which was twisted in a special manner so that it created a double helix with a small loop at its end (similar solution to previously presented by Kodomskoi). 79,80 The authors reported that the blunt loop ensures an atraumatic probing of Schlemm's canal, whereas the configuration as a double helix provides a good rigidity of the suture. A superficial and deep scleral flap was dissected so that the choroid was uncovered completely.…”

Section: Cathetherless Canaloplastymentioning

confidence: 99%

<p>Canaloplasty in the Treatment of Primary Open-Angle Glaucoma: Patient Selection and Perspectives</p>

Byszewska

Konopińska

Kicińska

et al. 2019

OPTH

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Catheter-independent suture probe canaloplasty with suprachoroidal drainage

Cited by 8 publications

References 16 publications

Modified suture-assisted canaloplasty in Asians with primary open-angle glaucoma: a prospective study with 12-month follow-up

Modified suture-assisted canaloplasty in Asians with primary open-angle glaucoma: a prospective study with 12-month follow-up

The Efficacy of Ab Externo Canaloplasty by Using a Nonabsorbable Suture and No Viscoelastics; IOP Results, Intraoperative and Early Complication Rates within 6-Month Follow-Up Period

<p>Canaloplasty in the Treatment of Primary Open-Angle Glaucoma: Patient Selection and Perspectives</p>

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