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Canaloplasty with Stegmann's Canal Expander ® for open‐angle glaucoma
Author(s) -
Stangos A.,
Mameletzi E.,
Sunaric Megevand G.
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/j.1755-3768.2016.0617
Subject(s) - medicine , hyphema , glaucoma , intraocular pressure , ophthalmology , complication , surgery , schlemm's canal , open angle glaucoma , trabecular meshwork
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. All cases were operated by the same surgeon using a standardized canaloplasty procedure with 360‐degrees dilatation of Schlemm's canal (SC) using a flexible ophthalmic microcannula followed by the insertion of the expander 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. Results 44 eyes of 42 consecutive patients included. 38 (86%) were Caucasians; 32 (73%) female; primary‐, pseudoexfoliative‐, pigmentary‐ OAG had 25 (57%), 17 (39%), 2 (4%) respectively; 30 (68%) were pseudophakic; mean age (±SD) was 77 ± 8 years. All patients reached month‐6 follow‐up visit (range: 6–24). Mean IOP decreased from 22.4 ± 7.8 mmHg before surgery to 8.4 ± 4.2, 12.05 ± 3.59, 11.07 ± 4.08, 11.3 ± 3.51, 11.2 ± 2.6, 11.1 ± 2.7, 11.6 ± 2.3 at day‐1, week‐1, month‐1, ‐3, ‐6, ‐12, ‐24 respectively (p < 0.01). Mean number of glaucoma medications reduced from 3.36 ± 0.74 before surgery to 0.15 ± 0.47 at the last recorded visit (p < 0.01, Wilcoxon). No complication was recorded in 20 eyes (45%); a spontaneously‐resolving hyphema in 14 (32%); a choroidal detachment in 4 eyes (9%); a Descemet's membrane detachment and anterior uveitis each in 3 eyes (7%). Uneventful insertion was achieved in 29 eyes (66%). The stent was trimmed in 2 eyes (4.5%) due to some resistance during insertion and it was inserted only in one side in 8 eyes (18%). Conclusions Canaloplasty with Stegmann's expander appears to reduce IOP in OAG with minor and self‐limited complications.