Efficacy of bleb‐independent penetrating canaloplasty in primary angle‐closure glaucoma: one‐year results. Issue 1 (20th April 2021)

• Record Type: Journal Article
• Authors: Zhang, Shaodan; Hu, Cheng; Cheng, Huanhuan; Gu, Juan; Samuel, Kwizera; Lin, Haishuang; Deng, Yuxuan; Xie, Yanqian; Hu, Jingjing; Le, Rongrong; Xu, Shuxia; Tham, Clement C.; Liang, Yuanbo
• Is Part Of: Acta ophthalmologica. Volume 100:Issue 1(2022)
• Page Start: e213
• Page End: e220
• Publication Date: 2021-04-20
• Subjects: bleb‐independent filtering surgery -- intraocular pressure -- penetrating canaloplasty -- primary angle‐closure glaucoma; Ophthalmology -- Periodicals; 617.7005
• DOI: 10.1111/aos.14869
• Languages: English
• ISSNs: 1755-375X

Abstract

Abstract: Purpose: To report the efficacy and safety of bleb‐independent penetrating canaloplasty in the management of primary angle‐closure glaucoma (PACG). Methods: This single‐centre prospective interventional case series enrolled 57 eyes from 53 PACG patients with medically uncontrolled intraocular pressure (IOP) and peripheral anterior synechiae of over 270°. Penetrating canaloplasty, mainly consisted of tensioning suture‐aided Schlemm's canal dilation and a trabeculectomy, was performed to create a direct communication between the anterior chamber and the Schlemm's canal. Postoperative IOP, number of glaucoma medications and procedure‐related complications were evaluated. Rate of success was defined as IOP ≤ 21, ≤18 and ≤15 mmHg, and a ≥30% IOP reduction without (complete) or with/without (qualified) IOP‐lowering medications. Results: A total of 45 eyes had 360° catheterization successfully completed. The mean preoperative IOP was 33.9 ± 11.7 mmHg (range, 13–59.6 mmHg), on 3.2 ± 0.8 glaucoma medications (range 2–5), which was decreased to 15.4 ± 3.7 mmHg (range, 8.6–22.5) and 0.2 ± 0.6 (range, 0–3) medications at 6 months and 14.8 ± 3.5 mmHg (range, 9–24) and 0.1 ± 0.3 (range, 0–1) medications at 12 months postoperatively. Complete success at 12 months were achieved in 78.9% (95% CI: 0.65–0.93), 71.1% (0.56–0.86) and 50.0% (0.33–0.67) eyes at IOP ≤ 21, ≤18 and ≤15 mmHg, respectively. Transient IOP elevation (>30 mmHg, 26.7%) and hyphema (11.1%) were the most common early surgical complications. Conclusion: Penetrating canaloplasty in PACG appeared to have good efficacy and safety profiles in this pilot study. Further studies are justified.