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Alexandros Pappas, Regine Pappas, Amber Rhodes; Success of Intraocular Pressure Control in Glaucoma Patients Undergoing Canaloplasty with and without Cataract Extraction in a Single Center Setting. Invest. Ophthalmol. Vis. Sci. 2014;55(13):3172.
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To evaluate the effectiveness of Canaloplasty in reducing IOP in patients with Glaucoma, while also evaluating the complication rate of the procedure. This allowed comparative analysis of the procedure when performed alone in a single operation versus when it is combined with cataract extraction.
A retrospective review of patients undergoing Canaloplasty performed by a single surgeon between the months of April 2008 to December 2010. Detailed preoperative and operative data was recorded. Postoperative data collection included postop IOPs, measured at postoperative days one and seven, and then months one, three, and twelve. Accompanying this data was the number of glaucoma medications at each time point, flap suture lysis or removal, and the occurrence of complications. Success was defined as a postoperative IOP<18 mmHg with or without medications, and no need for additional glaucoma surgery.
The patient records of 61 eyes that underwent either Canaloplasty alone or Canaloplasty combined with cataract extraction were reviewed. 5 eyes did not undergo successful completion of the Canaloplasty procedure and were converted to Trabeculectomy. One eye was excluded for insufficient data due to patient noncompliance. There were 38 females and 17 males that had successful completion of the Canaloplasty procedure (total n=55 eyes). 36 eyes underwent Canaloplasty combined with cataract extraction and 19 eyes underwent Canaloplasty alone. In the Canaloplasty alone group, mean preoperative IOP was 22.32 mmHg. The post-operative one-month IOP was 13.94 mm Hg, and at one year the IOP was 14.79 mmHg. In the combined Canaloplasty and cataract extraction group, mean preoperative IOP was 18.20 mmHg. At one month IOP was 12.03 mmHg, and at one year IOP was 13.08 mmHg. The overall data for all eyes in both groups had a preoperative IOP of 19.73 mmHg. For post-op day one the IOP was 12.35 mmHg, at month one IOP was 12.68 mm Hg, and year one IOP was 13.81 mmHg.
In this series, Canaloplasty was noted to be an effective and very safe technique to gain control of intraocular pressure for as long as 12 months following the procedure; while at the same time substantially reducing the number of glaucoma medications required to control IOP. The benefits of Canaolplasty were seen when combined with cataract extraction and when performed alone.
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