Viscocanalostomy combined with nearly 360-degree suture trabeculotomy for the treatment of primary congenital glaucoma: a preliminary report of a novel technique for trabeculotomy

Liang, Ya; Yu, Qingliang; Ji, Fangfang; Sun, Hong; Yuan, Zhilan

doi:10.1007/s00417-019-04537-2

Cited by 9 publications

(16 citation statements)

References 31 publications

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“…Three modifications were made to improve the efficacy of canaloplasty, including SC opening by viscocanalostomy, circumferential probing by a twisted 6/0 suture, and loose suture of the superior scleral flap. Attributed to our experience of viscocanalostomy for over twenty years [ 7 , 14 , 16 ], SC was accurately located during the dissection of the deep scleral flap. Twisted 6/0 suture was selected for its superior physical and chemical properties, which were demonstrated in the previous part.…”

Section: Discussionmentioning

confidence: 99%

“…SC was dilated, facilitating suture probing afterward. The viscoelastic may be pushed forward by the tip of the suture; thus, the whole SC and distal outflow way of the aqueous humor could be dilated during suture cannulation [ 7 ]. Then, a twisted 6/0 polypropylene suture was made.…”

Section: Methodsmentioning

confidence: 99%

“…However, the illumination equipment is so expensive that most patients cannot afford undergoing surgery, especially in developing countries. Furthermore, we previously reported that the suture was superior to the microcatheter in terms of flexibility for probing of SC[ 7 ]. Smith firstly tried a fine nylon suture to traverse almost half the circumference of the SC[ 8 ].…”

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: Methodsmentioning

confidence: 99%

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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“…Some studies demonstrated that HCD and C/D were reversible with a durable control of IOP in children with PCG (Celea et al 2016;Khalil & Abdelhakim 2016;Liang et al 2020). In the present study, both groups achieved a high proportion of qualified IOP control during the one-year follow-up, leading to reduced HCD and C/D at six months postoperatively.…”

Section: Discussionmentioning

confidence: 99%

“…A 5/0 Prolene suture could be passed through one end of SC to the other end and then guide the near-360degree trabeculotomy. We previously reported that the success rate of circumferential cannulation by suture was 84.8% in a PCG case series (Liang et al 2020). Here, we compared the efficacy and safety of viscocanalostomy plus near-360-degree suture trabeculotomy (VST) with viscocanalostomy plus trabeculotomy (VT) in a retrospective manner.…”

Section: Introductionmentioning

confidence: 99%

Comparison of viscocanalostomy plus suture‐assisted near‐360‐degree trabeculotomy and viscocanalostomy plus rigid probe trabeculotomy in primary congenital glaucoma

Liang

et al. 2021

Acta Ophthalmologica

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Purpose To compare the efficacy and safety of viscocanalostomy plus near‐360‐degree suture trabeculotomy (VST) with viscocanalostomy plus rigid probe trabeculotomy (VT) in treating primary congenital glaucoma (PCG) over a one‐year follow‐up. Methods This consecutive retrospective study included patients with PCG confirmed within 3 years of age from March 2017 to October 2019. Efficacy was evaluated by comparing the postoperative intraocular pressure (IOP) curve and the success rate at one year after surgery. Safety was assessed by comparing the postoperative complications. The number of anti‐glaucoma agents, horizontal corneal diameter (HCD) and cup‐to‐disc ratio (C/D) of the two surgical methods were also compared. Results Data of 90 eyes from 61 patients were analysed. The baseline parameters of the two groups were similar. The IOP at 12 months after surgery in the VST group was 12.7 ± 4.8 mmHg, while that in the VT group was 15.8 ± 6.5 mmHg. The IOP at 6, 9 and 12 months postoperatively in the VST group was significantly lower than in the VT group (p < 0.05). Viscocanalostomy plus near‐360‐degree suture trabeculotomy (VST) remained a significant favourable factor for complete one‐year success (93.6% versus 74.4%, p = 0.005) but not qualified one‐year success (97.9% versus 88.4%, p = 0.06). The number of anti‐glaucoma agents, HCD and C/D were reduced in both groups. Postoperative complications were not significantly different between the two groups. Conclusions In children with PCG, VST provides a more durable IOP control than VT over the one‐year follow‐up, with a similar safety profile.

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Viscocanalostomy combined with trabeculotomy for management of refractory primary congenital glaucoma

Vahedian

Fakhraie

Ahmed

2022

Journal of American Association for Pediatric Ophthalmology and

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Viscocanalostomy combined with nearly 360-degree suture trabeculotomy for the treatment of primary congenital glaucoma: a preliminary report of a novel technique for trabeculotomy

Cited by 9 publications

References 31 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

Comparison of viscocanalostomy plus suture‐assisted near‐360‐degree trabeculotomy and viscocanalostomy plus rigid probe trabeculotomy in primary congenital glaucoma

Viscocanalostomy combined with trabeculotomy for management of refractory primary congenital glaucoma

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