Ab Interno Canaloplasty after failed Trabeculectomy in uncontrolled Open-Angle Glaucoma

Abstract

Purpose : To introduce an alternative surgical treatment for the management of uncontrolled open-angle glaucoma after failed trabeculectomy and report the outcomes in a consecutive series of patients.

Methods : Single center, retrospective, non-comparative, interventional, case series.
We reviewed 9 eyes of 7 patients with uncontrolled OAG who underwent Ab interno canaloplasty after failed trabeculectomy. Outcomes measures included intraocular pressure, glaucoma medication, visual acuity and number of visits in postoperative care.

Results : In all patients ab interno canaloplasty after failed trabeculectomy was successfully done, a condition required to leading canulation and viscodilation of schlemm`s canal was that the ostium of the trabeculectomy had to be anterior to the trabecular meshwork. Preoperative mean IOP was 17±2.66 mmhg and postoperative mean IOP at 6 months was 12.2 ±1.66 mmhg. There was a total reduction of 29.3% of IOP at 6 months follow-up. Glaucoma medications reduced from 3.5 ±1.5 to 1.14±0.85.
At final visit 60% of the patients with 1 glaucoma medication and 10% without glaucoma medication. Visual acuity remains stable at 6 months. Numbers of visits after surgery were 4±1 in 6 months leading the patient rapid reincorporation of daily normal activities.
The only Complication was hyphema in 50% of the patients, that resolves 1 week later without reintervention.

Conclusions : In patients with uncontrolled OAG after failed trabeculectomy abic appears to be a safe and effective procedure. At 6 months follow-up reduction in IOP remain stable and reduction in glaucoma medications was significantly reduce.

This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.