July 2018
Volume 59, Issue 9
Open Access
ARVO Annual Meeting Abstract  |   July 2018
Long-term Results of Canaloplasty with Stegmann’s Canal Expander® for Open-angle Glaucoma
Author Affiliations & Notes
  • Irene Brazitikos
    Memorial A de Rothschild, Clinical Eye Research Centre, Geneva, Switzerland
  • Alexandros Stangos
    Memorial A de Rothschild, Clinical Eye Research Centre, Geneva, Switzerland
    Centre Ophtalmologique de Florissant, Geneva, Switzerland
  • Evangelia Mameletzi
    Memorial A de Rothschild, Clinical Eye Research Centre, Geneva, Switzerland
    Centre Ophtalmologique de Florissant, Geneva, Switzerland
  • Gordana Sunaric-Megevand
    Memorial A de Rothschild, Clinical Eye Research Centre, Geneva, Switzerland
    Centre Ophtalmologique de Florissant, Geneva, Switzerland
Investigative Ophthalmology & Visual Science July 2018, Vol.59, 2061. doi:
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      Irene Brazitikos, Alexandros Stangos, Evangelia Mameletzi, Gordana Sunaric-Megevand; Long-term Results of Canaloplasty with Stegmann’s Canal Expander® for Open-angle Glaucoma. Invest. Ophthalmol. Vis. Sci. 2018;59(9):2061.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : To evaluate the surgical outcome of canaloplasty using Stegmann’s canal expander in open-angle glaucoma (OAG).

Methods : Prospective, non-comparative, interventional study. We recruited patients with uncontrolled OAG between September 2013 and January 2017. All cases were operated by the same surgeon using a standardized canaloplasty procedure with 360-degree dilatation of Schlemm’s canal (SC) using a flexible ophthalmic microcannula (iScience Surgical Corporation, Menlo Park, CA) followed by the insertion of Stegmann’s expander (Ophthalmos GmbH, Switzerland) into both surgically created SC ostia. Primary outcomes: mean change in intraocular pressure (IOP) and number of glaucoma medications following surgery. Secondary outcomes: complication rates; percentage of eyes with successful insertion of the expander in SC; percentage of eyes with postoperative IOP ≤ 14mmHg and extent of SC expansion on swept-source optical coherence tomography (SS-OCT) at final visit.

Results : We recruited 51 eyes of 36 consecutive patients. Demographics: 32 (89%) were Caucasians; 29 (80%) female; primary-, pseudoexfoliative-, pigmentary- OAG had 32 (63%), 17 (33%), 2 (4%) respectively; 30 (59%) were pseudophakic; mean age (±SD) was 73.5 ± 10.8 years. All patients reached month-6 follow-up visit (range: 6-48). Mean IOP decreased from 19.7 ± 6.9 mmHg before surgery to 5.2 ± 4.1, 7.9 ± 3.8, 11.68 ± 3.5, 10.4 ± 3.2, 11.3 ± 4, 11.6 ± 2.9, 11.4 ± 2.1, 11.2 ± 2.3, 12.0 ± 0 at day-1, week-1, month-1, -3, -6, -12, -24, -36, -48 respectively (p < 0.01). Mean number of glaucoma medications reduced from 3.22 ± 1.01 before surgery to 0.5 ± 1.07 at the last recorded visit (p < 0.01, Wilcoxon). No complication was recorded in 19 eyes (37%); a spontaneously-resolving hyphema in 22 (43%); a choroidal detachment in 4 eyes (8%); a Descemet’s membrane detachment and anterior uveitis each in 3 eyes (6%). YAG-laser goniopuncture was performed in 13 eyes (25%), all before month-6 visit (64% at week-1). Uneventful canal expander insertion was achieved in 34 eyes (67%). At final visit, 86% had postoperative IOP ≤ 14 mmHg and mean post-operative SC diameter was 227.73 ± 125.5 μm.

Conclusions : Canaloplasty with Stegmann’s expander can reduce IOP in OAG with minor and self-limited complications in most cases. SS-OCT shows an expansion of SC.

This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.

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