Open-angle glaucoma Mexican patients treated with Canaloplasty: 18-month post-operative report from a 5-year follow-up.

Abstract

Purpose : Several studies have described the efficacy of canaloplasty for lowering the intraocular pressure (IOP) and thus slowing the rate of progression of glaucoma in different populations. We performed a prospective, experimental, 5-year follow-up, pilot study in Mexican patients with open-angle glaucoma (OAG) to evaluate if canaloplasty intervention effectively decreases the IOP to ranges where progression does not occur.

Methods : Eleven OAG eyes from 9 patients, without previous glaucoma surgery, were included in the study. Full ophthalmologic examination was performed, as well as achromatic visual fields (AVF), optical coherence tomography (OCT) of the optic nerve and retinal nerve fiber layer. All patients underwent canaloplasty, which was performed with the Glaucolight device (DORC®). A follow-up evaluation was done 24 hours after surgery and then repeated at week 1, 2, 4 and 8; evaluations were done at the 4^th, 6^th, 8^th, 10^th, 12^th, 14^th, and 18^th months. The best-corrected visual acuity (BCVA) and IOP were measured at every visit and in the 6,12 and 18- month visits VF and OCT were performed to assess disease progression. Data from patient 3 is missing in this report due to exclusion in month 14 of follow-up for causes unrelated to the study.

Results : The descriptive variables of the study group are presented in table 1. Eighteen-month-follow-up IOP in all eyes was statistically significantly lower compared to basal IOP (14.1± 2.4; p<0.000), and pre-operative IOP (15.6 ± 2.7; p<0.000). At the beginning of the study 1 patient was using 1 hypotensive medication, 2 patients were using 2, 6 subjects needed 3, and 2 needed 4; during the 6,12 and 18-month follow-ups none of the patients required hypotensive treatment. No statistical significant difference was observed between the basal and 18- month AVF and OCT.

Conclusions : Eyes treated with canaloplasty, after 18 months of follow-up, showed lower IOPs compared with the pre-operative and basal ones, without topical hypotensive medication. None of the patients disclosed progression of the disease evaluated with AVF and OCT. All patients showed stability compared to the 6 and 12-month follow-ups previously reported. It will be interesting to evaluate the clinical/functional outcome of the subjects after 24 months of follow-up.

This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.