Circumferential Schlemm’s Canal Surgery in Adult and Pediatric Glaucoma

Elhusseiny, Abdelrahman M.; Sayed, Yasmine M. El; Sheikh, Reem H El; Gawdat, Ghada; Elhilali, Hala

doi:10.1080/02713683.2019.1659975

Cited by 23 publications

(25 citation statements)

References 73 publications

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“…However, mastering this surgical technique requires a long learning curve because of many factors such as the complexity of anatomical factors. In addition, experienced surgeons have high variability in whether they can successfully dissect the SC ( 3 , 9 , 10 ). Therefore, glaucoma doctors must find a tool to replace manual operation, simplify canal opening, improve the safety and effectiveness of SC opening and shorten the learning cycle of surgeons.…”

Section: Discussionmentioning

confidence: 99%

“…Ab externo SC surgery, including viscocanalostomy or canaloplasty, has been highlighted ( 2 ). As a bleb-independent surgical approach, it has shown good results in IOP reduction ( 3 , 4 ). Precise location and correct dissection (SC outer wall) are important to achieve successful SC surgery, which requires a long learning curve, and such processes are technically challenging in conventional SC surgery using a surgical knife.…”

Section: Introductionmentioning

confidence: 99%

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Clinical application of the CO2 laser in Ab externo Schlemm's canal surgery

et al. 2022

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PurposeThis study aimed to investigate the clinical application of laser as a knife in Ab externo Schlemm's canal (SC) surgery and compare the efficacy and safety of the CO2 laser with the conventional procedure using a surgical knife.MethodsPatients who underwent either canaloplasty or trabeculotomy with CO2 laser system which was used to locate and ablate the outer wall of SC at the time interval between May 2020 and May 2021 were identified, their medical files were reviewed, and their results were compared with conventional surgery group who underwent canaloplasty or trabeculotomy with conventional surgical knife at the same time period. The following datas were conducted and compared: age, sex, intraocular pressure (IOP), number of drugs, best-corrected visual acuity (BCVA), mean deviation and pattern standard deviation of visual field examination, SC opening related complications.ResultsA total of 49 patients (49 eyes) were included in this study, including 23 in the Laser surgery group and 26 in the conventional surgery group. Time for SC opening was 49.33 ± 25.23 s and 116.50 ± 31.79 s for laser surgery group and conventional surgery group, respectively. This difference between the two groups was statistically significant (P < 0.01). Hemorrhage occurred in five eyes during ablation for the laser surgery group and in 24 eyes for the conventional surgery group. In addition, anterior chamber penetration occurred in two cases for the laser surgery group and in six cases for the conventional surgery group. The success rate of identifying and opening outer wall of SC was 91.30% (21 eyes) for the laser surgery group and 76.92% (20 eyes) for the conventional surgery group. The difference between preoperative and postoperative intraocular pressure for each group was statistically significant (P < 0.01), and there were no statistically significant differences across the two groups in terms of postoperative IOP (P = 0.238) and BCVA (P = 0.389).ConclusionCompared with the conventional procedure using a surgical knife, CO2 laser-assisted ablation of the outer wall of SC was less time-consuming and less technically challenging. CO2 laser-assisted ablation also resulted in fewer complications. Furthermore, it had a shorter learning curve and a higher success rate of identifying and opening SC.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Clinical application of the CO2 laser in Ab externo Schlemm's canal surgery

et al. 2022

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“…In the past 10 years, circumferential trabeculotomy has been performed in adult patients with open-angle glaucoma (14). However, only a few reports have been conducted on the effectiveness of a 360 • external trabeculotomy in treating adults with POAG or secondary open-angle glaucoma thus far (24). Chin et al used a modified 360 • external suture trabeculotomy to manage adult open-angle glaucoma (25).…”

Section: Discussionmentioning

confidence: 99%

Microcatheter-Assisted Trabeculotomy Combined With Deep Sclerectomy and Trabeculectomy in Young to Middle-Aged Adults With Advanced Primary Open-Angle Glaucoma: 1-Year Result

Zhang

Yan

et al. 2021

Front. Med.

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Objective: We aimed to evaluate the safety and clinical efficacy of ab externo microcatheter-assisted trabeculotomy combined with deep sclerectomy and trabeculectomy (MATT-DS-Trab) in the surgical management of advanced primary open-angle glaucoma (POAG).Methods: According to the inclusion criteria, we retrospectively collected and analyzed 37 POAG cases in advanced stage who received MATT-DS-Trab. The intraocular pressure (IOP), best corrected visual acuity (BCVA), use of anti-glaucoma drugs, shape of the filtering bleb, size of the scleral lake, complications, and the surgical success rate were recorded.Results: The mean IOP was 37.50 ± 8.11 mmHg before the operation, while it depleted to 10.08 ± 2.01 and 11.43 ± 2.07 mmHg at 1 week and 12 months after the operation, respectively (both P < 0.001 compared to preoperative IOP). From none to two kinds of anti-glaucoma drugs were used 12 months after surgery on the patients, which were significantly reduced compared with that preoperatively (P < 0.001). An L-type filtering bleb was the main form at all time points after the operation. At 12 months following surgery, an F-type filtering bleb accounted for 5.41% and no E-type filtering bleb was recorded. The length and height of the scleral lake shrunk with time, but there was no statistical significance (P > 0.05). Also, there was no correlation between the size of the scleral pool and the IOP (P > 0.05). At 12 months after the operation, the complete success rates were 94.59, 83.78, and 72.97% according to standards A (≤18 mmHg), B (≤15 mmHg), and C (≤12 mmHg), respectively. Intraoperative complications were mainly anterior chamber hemorrhage, and no complications related to the filtration bleb were observed after the operation.Conclusion: Based on multichannel mechanisms, MATT-DS-Trab is able to effectively reduce IOP in advanced POAG patients, with few serious complications and a high success rate.

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“…Glaucoma management in pediatric patients is challenging due to the lack of cooperation of these patients. However, effective management is necessary in order to prevent visual loss and prevent damage to the cornea and optic nerve [16]. Also, glaucoma after corneal graft surgery can potentially lead to visual loss and graft failure [17].…”

Section: Case Reports In Ophthalmological Medicinementioning

confidence: 99%

Case Series of Brittle Cornea Syndrome

Eleiwa

Raheem

Patel

et al. 2020

Case Reports in Ophthalmological Medicine

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Purpose. This case series demonstrate diagnostic features, treatment options, and challenges for Brittle Cornea Syndrome. Observations. Three cases presented with bluish sclera and extremely thin cornea. Genetic workup was performed and confirmed the diagnosis of Brittle Cornea Syndrome, a rare autosomal recessive disorder characterized by corneal thinning and blue sclera. Case 1 was a 4-year-old boy who developed cataract and glaucoma after undergoing right tectonic penetrating keratoplasty (PK) secondary to a spontaneous corneal rupture. Glaucoma was controlled medically. Later, the kid underwent right transcorneal lensectomy and vitrectomy with synechiolysis. After 6 weeks, he sustained graft dehiscence that was repaired using onlay patch graft. Case 2 was a 7-year-old boy who underwent PK in the right eye, then a pericardial patch graft in the left eye following spontaneous corneal rupture. Glaucoma in both eyes was controlled medically. Case 3 was the 2-year-old sister of the 2nd case. She had a pachymetry of 238 μm OD and 254 μm OS. In the 3 cases, parents were instructed to take protective measures for both eyes and to continue with follow-up visits. Also, they were instructed to have regular screenings for late-onset hearing loss, dental abnormalities, and bone deformities. Conclusions. Long-term follow-up of children diagnosed with Brittle Cornea Syndrome is paramount to minimize the morbidity of corneal rupture and late-onset extraocular conditions.

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Circumferential Schlemm’s Canal Surgery in Adult and Pediatric Glaucoma

Cited by 23 publications

References 73 publications

Clinical application of the CO2 laser in Ab externo Schlemm's canal surgery

Clinical application of the CO2 laser in Ab externo Schlemm's canal surgery

Microcatheter-Assisted Trabeculotomy Combined With Deep Sclerectomy and Trabeculectomy in Young to Middle-Aged Adults With Advanced Primary Open-Angle Glaucoma: 1-Year Result

Case Series of Brittle Cornea Syndrome

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