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Huiyi Chen, Darrell WuDunn, Louis B Cantor; Long-term clinical results of canaloplasty in open angle glaucoma. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):2683.
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Our previous study showed canaloplasty with phaco has better IOP-lowering effects compared to phaco alone. This study is to present the long-term clinical results on efficacy and survival of IOP-lowering effect of canaloplasty surgery in open angle glaucoma.
This is a retrospective study on consecutive canaloplasty with or without phaco performed by 1 surgeon in open-angle glaucoma patients from 1/1/2008 to 6/30/2014. Intraocular pressure (IOP), number of medications, and complications were analyzed. Survival rates were analyzed using the Kaplan-Meier life-table analysis. Success criteria were IOP less than 21mmHg and one of the followings: 25% or greater reduction in IOP; or 15% or greater reduction in IOP on at least one fewer medication; or equal or lower IOP on at least 2 fewer medications.
Sixty four eyes from 48 patients underwent canaloplasty with phaco (56 eyes) or canaloplasty only (8 eyes). There were 25 males and 23 females; 46 Caucasian and 2 African-Americans. The follow-up ranged from 1- 76 months with mean 33.2±24.3 months. The mean age was 72.3±10.0 years. The mean preoperative IOP was 19.4±5.9 mmHg. The mean IOP at the final follow-up was 16.2±9.3 mm Hg (P=0.0021). The mean preoperative number of medications was 2.0±1.2. The mean number of medications at the final follow-up was 0.7±1.3 (P<0.0001). The most frequently seen complications included: hyphema on post-operative day 1 in 37 eyes (57.8%) which resolved by 1 week visit, sub-Descemet membrane hemorrhage in 4 eyes (6.3%) which slowly resolved over several months, and IOP spike >10 mmHg on day 1 in 10 eyes (15.6%). The Kaplan-Meier life-table analysis shows mean survival for canaloplasty using the criteria above was 52 months.
Canaloplasty surgery effectively reduced the IOP and the number of glaucoma medications needed in open angle glaucoma patients. Canaloplasty resulted in few serious complications. The long-term results are promising. Our study suggests canaloplasty achieves good long term IOP control and remains an effective procedure for open angle glaucoma patients.
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