Efficacy, Safety, and Survival Rates of IOP-lowering Effect of Phacoemulsification Alone or Combined With Canaloplasty in Glaucoma Patients

Abstract

A combination of canaloplasty with phaco results in a decreased number of glaucoma medications and increased survival rate of IOP-lowering effect compared with phaco alone.

Trabeculectomy versus canaloplasty (TVC study) in the treatment of patients with open‐angle glaucoma: a prospective randomized clinical trial

“…An intracorneal haematoma is rare and can be removed by stab incision (Tetz et al 2013), partial-thickness paracentesis (Gismondi & Brusini 2011) or Nd: YAG laser Descemet membranotomy (Robert & Harasymowycz 2013). Perforation of the trabeculo-Descemet window during dissection is an intraoperative complication during canaloplasty, which occurs in <10% of all cases (Shingleton et al 2008;Lewis et al 2009;Grieshaber et al 2010;Ayyala et al 2011;Bull et al 2011;Arthur et al 2013;Tetz et al 2013). These data are in line with our observations of Descemet detachment (6.7%) and hyphaema rate (23.3%) following canaloplasty.…”

“…In line with our results, Ayyala et al (2011) observed a more pronounced IOP reduction after 12 months with fewer medications in trabeculectomy (mean 43%) than canaloplasty (mean 32%). Canaloplasty had a better IOP reduction when performed in combination with cataract surgery (Lewis et al 2007(Lewis et al , 2011Shingleton et al 2008;Bull et al 2011;Arthur et al 2013;Tetz et al 2013). …”

“…With regard to complications, hyphaema is a common event after canaloplasty and is suggested as a positive predictor of surgical success as it indicates permeability of the distended trabecular meshwork (Shingleton et al 2008;Lewis et al 2009;Grieshaber et al 2010Grieshaber et al , 2013Ayyala et al 2011;Bull et al 2011;Arthur et al 2013;Matlach et al 2013;Tetz et al 2013). An intracorneal haematoma is rare and can be removed by stab incision (Tetz et al 2013), partial-thickness paracentesis (Gismondi & Brusini 2011) or Nd: YAG laser Descemet membranotomy (Robert & Harasymowycz 2013).…”

“…Previous studies comparing non-penetrating with penetrating glaucoma surgeries have reported that although canaloplasty may not be as effective as filtering surgery in lowering IOP without medication, complication rate and risk of serious vision-threatening adverse events are low (Ayyala et al 2011;Brusini & Tosoni 2012;Bruggemann et al 2013;Matlach et al 2013). In addition, the combination of canaloplasty with cataract surgery provides a better IOP reduction than single canaloplasty (Lewis et al 2007(Lewis et al , 2011Shingleton et al 2008;Bull et al 2011;Arthur et al 2013;Tetz et al 2013).…”

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

“…Conversely, following canaloplasty phacoemulsification only has a slightly positive impact with there being an overall benefit to the IOP lowering effects. [58][59][60] Canaloplasty may also be a safe and effective surgical option in patients with open-angle uveitic glaucoma, 61,62 although it is not widely considered a first choice surgery due to the possibility of late suture erosion through TM associated with inflammation in these patients. 61 This group of individuals is unique, with them being younger when compared to other OAG patients and their tendency to aggressive wound healing.…”