Top

Graefe's Archive for Clinical and Experimental Ophthalmology

Published in:

01-02-2020 | Glaucoma | Glaucoma

Outcomes of 360° suture trabeculotomy after unsuccessful canaloplasty

Authors: Sabine Baumgarten, David Kürten, Tibor Lohmann, Hannah Schellhase, Niklas Plange, Peter Walter, Matthias Fuest

Published in: Graefe's Archive for Clinical and Experimental Ophthalmology | Issue 2/2020

Abstract

Background

Canaloplasty is a well-established non-penetrating glaucoma surgery. Unsuccessful outcomes can be enhanced by micro-invasive 360° suture trabeculotomy (360°trabeculotomy), analyzed in this study.

Methods

This retrospective study included twenty eyes of 19 patients, mean age 59.7±17.2 years, with primary open-angle glaucoma (POWG n = 14), pseudoexfoliation glaucoma (PEX n = 3), juvenile glaucoma (n = 2) and aphakic glaucoma (n = 1), who underwent micro-invasive 360° trabeculotomy after unsuccessful (intraocular pressure (IOP) >21 mmHg under maximum glaucoma eye drop therapy (Meds)) canaloplasty. IOPs, Meds, complications and failure rates (IOP >21 mmHg at two consecutive follow-ups) were evaluated. Complete success (no Meds) and qualified success (with Meds) rates for IOP levels ≤21 mmHg and ≤ 18 mmHg at the last follow-up were evaluated.

Results

IOPs and Meds were significantly reduced from before to 1 week (10.3±3.1 days) after 360° trabeculotomy (IOP, 28.3±6.0 mmHg to 15.8±4.5 mmHg; p < 0.001; Meds, 3.1 ± 1.2 to 1.0 ± 1.2; p < 0.001). IOPs (p = 0.37) and Meds (p = 0.33) did not decrease further from 1 week until the last follow-up (18.3 ± 8.2 months (IOP, 14.4±3.8 mmHg; Meds, 1.5±1.3)).

Complete and qualified success was 25% (5/20) and 70% (14/20) for IOP ≤21 mmHg, as well as 25% (5/20) and 60% (12/20) for IOP ≤18 mmHg. Four eyes had postoperative hyphema, which resolved after a mean period of 4.0 ± 2.2 days. Five failures occurred after a mean of 40.6 ± 51.9 days after 360° trabeculotomy. All failures underwent trabeculectomy. Eyes that needed early (≤3 months post canaloplasty) 360° trabeculotomy showed higher IOPs before (p < 0.001) and lower (p = 0.03) IOPs 2 months post 360° trabeculotomy than eyes with late (>3 months) 360° trabeculotomy surgery.

Conclusions

360° trabeculotomy is a safe, micro-invasive, simple and successful method to enhance failed canaloplasty.

Grieshaber MC (2012) Ab externo Schlemm's canal surgery: viscocanalostomy and canaloplasty. Dev Ophthalmol 50:109–124. https://doi.org/10.1159/000334793 CrossRefPubMed

Crandall AS (1999) Nonpenetrating filtering procedures: viscocanalostomy and collagen wick. Semin Ophthalmol 14(3):189–195. https://doi.org/10.3109/08820539909061473 CrossRef

Brusini P (2014) Canaloplasty in open-angle glaucoma surgery: a four-year follow-up. ScientificWorldJournal 2014:469609. https://doi.org/10.1155/2014/469609 CrossRefPubMedPubMedCentral

Lewis RA, von Wolff K, Tetz M, Koerber N, Kearney JR, Shingleton BJ, Samuelson TW (2011) Canaloplasty: Three-year results of circumferential viscodilation and tensioning of Schlemm canal using a microcatheter to treat open-angle glaucoma. J Cataract Refract Surg 37(4):682–690. https://doi.org/10.1016/j.jcrs.2010.10.055 CrossRefPubMed

Khaimi MA, Dvorak JD, Ding K (2017) An Analysis of 3-year outcomes following canaloplasty for the treatment of open-angle glaucoma. J Ophthalmol 2017:2904272. https://doi.org/10.1155/2017/2904272 CrossRefPubMedPubMedCentral

Bull H, von Wolff K, Korber N, Tetz M (2011) Three-year canaloplasty outcomes for the treatment of open-angle glaucoma: European study results. Graefes Arch Clin Exp Ophthalmol 249(10):1537–1545. https://doi.org/10.1007/s00417-011-1728-3 CrossRefPubMed

Seuthe AM, Januschowski K, Szurman P (2016) Micro-invasive 360-degree suture trabeculotomy after successful canaloplasty - one year results. Graefes Arch Clin Exp Ophthalmol 254(1):155–159. https://doi.org/10.1007/s00417-015-3192-y CrossRefPubMed

Matlach J, Dhillon C, Hain J, Schlunck G, Grehn F, Klink T (2015) Trabeculectomy versus canaloplasty (TVC study) in the treatment of patients with open-angle glaucoma: a prospective randomized clinical trial. Acta Ophthalmol 93(8):753–761. https://doi.org/10.1111/aos.12722 CrossRefPubMedPubMedCentral

Grieshaber MC, Pienaar A, Olivier J, Stegmann R (2010) Canaloplasty for primary open-angle glaucoma: long-term outcome. Br J Ophthalmol 94(11):1478–1482. https://doi.org/10.1136/bjo.2009.163170 CrossRefPubMed

10.

Lewis RA, von Wolff K, Tetz M, Korber N, Kearney JR, Shingleton B, Samuelson TW (2007) Canaloplasty: circumferential viscodilation and tensioning of Schlemm's canal using a flexible microcatheter for the treatment of open-angle glaucoma in adults: interim clinical study analysis. J Cataract Refract Surg 33(7):1217–1226. https://doi.org/10.1016/j.jcrs.2007.03.051 CrossRefPubMed

11.

Shingleton B, Tetz M, Korber N (2008) Circumferential viscodilation and tensioning of Schlemm canal (canaloplasty) with temporal clear corneal phacoemulsification cataract surgery for open-angle glaucoma and visually significant cataract: one-year results. J Cataract Refract Surg 34(3):433–440. https://doi.org/10.1016/j.jcrs.2007.11.029 CrossRefPubMed

12.

Cagini C, Peruzzi C, Fiore T, Spadea L, Lippera M, Lippera S (2016) Canaloplasty: Current Value in the Management of Glaucoma. J Ophthalmol 2016:7080475. https://doi.org/10.1155/2016/7080475 CrossRefPubMedPubMedCentral

13.

Leske MC, Heijl A, Hyman L, Bengtsson B (1999) Early manifest glaucoma trial: design and baseline data. Ophthalmology 106(11):2144–2153. https://doi.org/10.1016/s0161-6420(99)90497-9 CrossRefPubMed

14.

Fuest M, Kuerten D, Koch E, Becker J, Hirsch T, Walter P, Plange N (2016) Evaluation of early anatomical changes following canaloplasty with anterior segment spectral-domain optical coherence tomography and ultrasound biomicroscopy. Acta Ophthalmol 94(5):e287–e292. https://doi.org/10.1111/aos.12917 CrossRefPubMed

15.

Gesser C, Klemm M (2014) Post-surgical treatment after non-penetrating glaucoma surgery: the goniopuncture. Klin Monbl Augenheilkd 231(6):631–635. https://doi.org/10.1055/s-0033-1351060 CrossRefPubMed

16.

Grieshaber MC, Fraenkl S, Schoetzau A, Flammer J, Orgul S (2011) Circumferential viscocanalostomy and suture canal distension (canaloplasty) for whites with open-angle glaucoma. J Glaucoma 20(5):298–302. https://doi.org/10.1097/IJG.0b013e3181e3d46e CrossRefPubMed

17.

Voykov B, Rohrbach JM (2016) Revision procedures after canaloplasty. Ophthalmologe 113(11):910–913. https://doi.org/10.1007/s00347-016-0314-9 CrossRefPubMed

18.

Matlach J, Freiberg FJ, Leippi S, Grehn F, Klink T (2013) Comparison of phacotrabeculectomy versus phacocanaloplasty in the treatment of patients with concomitant cataract and glaucoma. BMC Ophthalmol 13:1. https://doi.org/10.1186/1471-2415-13-1 CrossRefPubMedPubMedCentral

19.

Matthaei M, Steinberg J, Wiermann A, Richard G, Klemm M (2011) Canaloplasty : a new alternative in non-penetrating glaucoma surgery. Ophthalmologe 108(7):637–643. https://doi.org/10.1007/s00347-010-2305-6 CrossRefPubMed

20.

Tam DY, Barnebey HS, Ahmed II (2013) Nd: YAG laser goniopuncture: indications and procedure. J Glaucoma 22(8):620–625. https://doi.org/10.1097/IJG.0b013e31824d512a CrossRefPubMed

21.

Ethier CR, Kamm RD, Palaszewski BA, Johnson MC, Richardson TM (1986) Calculations of flow resistance in the juxtacanalicular meshwork. Invest Ophthalmol Vis Sci 27(12):1741–1750PubMed

22.

Seiler T, Wollensak J (1985) The resistance of the trabecular meshwork to aqueous humor outflow. Graefes Arch Clin Exp Ophthalmol 223(2):88–91CrossRef

23.

Brandao LM, Schotzau A, Grieshaber MC (2015) Suture distension of Schlemm's canal in canaloplasty: an anterior segment imaging study. J Ophthalmol 2015:457605. https://doi.org/10.1155/2015/457605 CrossRefPubMedPubMedCentral

24.

Grieshaber MC, Schoetzau A, Flammer J, Orgul S (2013) Postoperative microhyphema as a positive prognostic indicator in canaloplasty. Acta Ophthalmol 91(2):151–156. https://doi.org/10.1111/j.1755-3768.2011.02293.x CrossRefPubMed

25.

Koch JM, Heiligenhaus A, Heinz C (2011) Canaloplasty and transient anterior chamber haemorrhage: a prognostic factor? Klin Monbl Augenheilkd 228(5):465–467. https://doi.org/10.1055/s-0029-1245486 CrossRefPubMed

26.

Wallin O, Al-ahramy AM, Lundstrom M, Montan P (2014) Endophthalmitis and severe blebitis following trabeculectomy. Epidemiology and risk factors; a single-centre retrospective study. Acta Ophthalmol 92(5):426–431. https://doi.org/10.1111/aos.12257 CrossRefPubMed

27.

Robert MC, Harasymowycz P (2013) Hemorrhagic descemet detachment after combined canaloplasty and cataract surgery. Cornea 32(5):712–713. https://doi.org/10.1097/ICO.0b013e318281af48 CrossRefPubMed

28.

Grieshaber MC, Pienaar A, Olivier J, Stegmann R (2010) Comparing two tensioning suture sizes for 360 degrees viscocanalostomy (canaloplasty): a randomised controlled trial. Eye (Lond) 24(7):1220–1226. https://doi.org/10.1038/eye.2009.317 CrossRef

29.

Sihota R, Angmo D, Ramaswamy D, Dada T (2018) Simplifying "target" intraocular pressure for different stages of primary open-angle glaucoma and primary angle-closure glaucoma. Indian J Ophthalmol 66(4):495–505. https://doi.org/10.4103/ijo.IJO_1130_17 CrossRefPubMedPubMedCentral

Title: Outcomes of 360° suture trabeculotomy after unsuccessful canaloplasty
Authors: Sabine Baumgarten
David Kürten
Tibor Lohmann
Hannah Schellhase
Niklas Plange
Peter Walter
Matthias Fuest
Publication date: 01-02-2020
Publisher: Springer Berlin Heidelberg
Keywords: Glaucoma
Trabeculotomy
Trabeculectomy
Published in: Graefe's Archive for Clinical and Experimental Ophthalmology / Issue 2/2020
Print ISSN: 0721-832X
Electronic ISSN: 1435-702X
DOI: https://doi.org/10.1007/s00417-019-04545-2

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Outcomes of 360° suture trabeculotomy after unsuccessful canaloplasty

Abstract

Background

Methods

Results

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 2/2020

Viscocanalostomy combined with nearly 360-degree suture trabeculotomy for the treatment of primary congenital glaucoma: a preliminary report of a novel technique for trabeculotomy

Development of visual acuity under hyperbaric oxygen treatment (HBO) in non arteritic retinal branch artery occlusion

The effectiveness and safety of posterior scleral reinforcement with vitrectomy for myopic foveoschisis treatment: a systematic review and meta-analysis

Clinical and ASOCT evaluations of ‘bleb-sparing epithelial exchange’ in paediatric and adult dysfunctional blebs over 5 years

Risk factors associated with poor outcome after medial rectus resection for recurrent intermittent exotropia

SIRT1 is required for the neuroprotection of resveratrol on retinal ganglion cells after retinal ischemia-reperfusion injury in mice