Abstract
Purpose:
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.
Methods:
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.
Results:
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.
Conclusions:
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.