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Evaluation of early anatomical changes following canaloplasty with anterior segment spectral‐domain optical coherence tomography and ultrasound biomicroscopy
Author(s) -
Fuest Matthias,
Kuerten David,
Koch Eva,
Becker Jakob,
Hirsch Thalia,
Walter Peter,
Plange Niklas
Publication year - 2016
Publication title -
acta ophthalmologica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.534
H-Index - 87
eISSN - 1755-3768
pISSN - 1755-375X
DOI - 10.1111/aos.12917
Subject(s) - ultrasound biomicroscopy , sclera , optical coherence tomography , medicine , ophthalmology , ultrasound , schlemm's canal , nuclear medicine , glaucoma , trabecular meshwork , radiology
Purpose To analyse structural changes in conjunctiva, sclera and Schlemm's canal ( SC ) following canaloplasty with optical coherence tomography ( AS ‐ OCT ) and ultrasound biomicroscopy ( UBM ). Methods Fifteen patients undergoing canaloplasty were included in this prospective study. AS ‐ OCT images were acquired pre‐ and 1, 7, 30 and 90 days postoperatively. UBM was performed 3 months postoperatively. The surgical site was evaluated for the presence of SC , transscleral filtration, a scleral lake and the visibility of intra‐Schlemm‐sutures. The height and width of SC were measured at the 3 and 9 o'clock limbus position. Results After canaloplasty, SC was detectable with AS ‐ OCT in 93% of the patients on day 1. The increase in height was higher than that in width (height: +369%, p = 0.0004, width: +152%, p = 0.002). IOP was negatively correlated to SC 's width 1 week postoperatively ( r = −0.63, p = 0.04) and to SC's height until 3 months ( r = −0.66, p = 0.02) postoperatively. Using UBM , a reflection of the traction sutures indicated SC 's position in all patients. Transscleral filtration was found in all patients using AS ‐ OCT , demonstrating a peak 1 week postoperatively. At 3 months, a scleral lake could be visualized in 50% and 83% of patients using AS ‐ OCT and UBM , respectively. Conclusions AS ‐ OCT offers a high resolution for imaging superficial conjunctival areas and SC after canaloplasty, whereas UBM is capable of detecting deeper structures such as scleral lakes or intra‐canal‐sutures. The results imply a correlation of the dilation of SC with the IOP ‐lowering effect and an early pronounced transscleral filtration following canaloplasty.