Combined phacocanaloplasty for open-angle glaucoma and cataract: 12 months results

Abstract

Purpose of the studyTo evaluate efficacy, safety, and success rates of canaloplasty combined with phacoemulsification and intraocular lens implantation in patients with open-angle glaucoma (OAG) and visually significant cataract.Patients and methodsA prospective interventional noncomparative case series carried out in Minia University Hospital from April 2015 to October 2016 on 20 eyes of 18 patients who had visually significant cataract and primary OAG. All the cases had combined phacocanaloplasty. Preoperative best-corrected visual acuity, intraocular pressure (IOP), and number of antiglaucoma medications were collected and compared to postoperative levels, and complications rates were recorded.Results20 eyes of 18 patients (5 males and 15 females), with a mean age 57.6 years (range 48–69 years), underwent phacocanaloplasty. Preoperative mean IOP was 25.20 ±1.009 mmHg. Postoperative IOP decreased to a mean of 14.20±0.9, 14.85±0.8, and 15.85±0.7 mmHG at 3, 6, and 12 months, respectively, with 37% reduction from preoperative IOP level at one year follow-up visit (P=0.0005). The number of antiglaucoma medications dropped from mean of 1.55 preoperatively to 0.35 postoperatively. LogMAR of best-corrected visual acuity improved from 0.6950±0.07 preoperatively to 0.3670±0.056, 0.3460±0.056, and 0.03370±0.052 at 3, 6, and 12 months postoperatively (P=0.0005). Complications were limited to mild hyphemia (one case), mild corneal edema (one case), and mild inflammatory membrane (one case) that resolved in the first week after surgery.ConclusionCanaloplasty combined with clear corneal phacoemulsification and intraocular lens implantation may be a safe and effective procedure to lower IOP in adult patients with OAG and visually significant cataract.

Influence of the Water-Drinking Test on Intraocular Pressure, Schlemm's Canal, and Autonomic Nervous System Activity

“…29 Increasing the length of the dilated portion of SC improves outflow, as observed with treatment using SC scaffolds. 19,20 Genaidy et al 30 showed that canaloplasty successfully reduced the IOP from 25.2 6 1.009 mm Hg before surgery to 15.9 6 0.7 mm Hg at 1 year after surgery in eyes with primary open angle glaucoma. In our study, both SCAR(mean) and IOP changed synchronously in the first 15-minutes post-WDT and returned to baseline by 60-minutes post-WDT.…”

Effects of head posture on intraocular pressure and heart rate of human beings

“…found that canaloplasty (SC dilatation program) successfully decreased the IOP after 12 months in eyes with POAG. [ 26 ] In our study, the IOP peak after 20 min of head-down position might be explained by the collapse of the SC lumen of increased parasympathetic nervous activity.…”

Simultaneous influence of sympathetic autonomic stress on Schlemm’s canal, intraocular pressure and ocular circulation

“…found that reduction in SC dimensions in POAG eyes may account for approximately half of the decrease in outflow facility 26 . The SC has attracted considerable interest in recent years 27 . In this study, SCAR was found expanded and was correlated with the activation of SNS (LF/HF index).…”