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Canaloplasty may be safer treatment option for patients with open-angle glaucoma
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 Richard A. Lewis |
KAANAPALI, Hawaii — Canaloplasty may be a safer alternative to trabeculectomy for patients with open-angle glaucoma, according to a speaker here.
Richard A. Lewis, MD, told colleagues at the Hawaiian Eye 2011 meeting that nonpenetrating procedures such as canaloplasty (iScience) avoid the early and late postoperative complications of trabeculectomy, such as blebs and hypotony.
"Surgical manipulation of Schlemm's canal and the collector system to control pressure has long been a goal for glaucoma [management]," he said.
The procedure takes approximately 30 minutes, slightly longer than trabeculectomy, but this disadvantage is nullified by the relative ease of postoperative care, Dr. Lewis said.
Canaloplasty is particularly helpful for patients in whom trabeculectomy is likely to fail, such as those who have already undergone trabeculectomy in the fellow eye or those with hypotony or significant conjunctival disease. High myopes, contact lens wearers and patients undergoing immunosuppressive or anticoagulant therapy may also benefit from this procedure, Dr. Lewis said.
Three-year results from a study conducted by Dr. Lewis and colleagues will be published in the Journal of Cataract and Refractive Surgery.
At 3 years, patients who received canaloplasty treatment alone maintained a mean IOP of 15.4 mm Hg; those who underwent phaco and canaloplasty had a mean IOP of 13.6 mm Hg.
"One of the various criticisms I have gotten about this procedure is that it will not sustain its pressure reduction. So it is nice to see that, at least at 3 years, we have good results," Dr. Lewis said.
Early hyphema and Descemet's detachment, which occurred in a small percentage of patients, are potential complications after the procedure, he said.
- Disclosure: Dr. Lewis is a paid consultant for iScience Interventional.
Hawaiian Eye and Retina 2012 will be held January 15-20 at the Grand Wailea Resort & Spa in Maui. Learn more at OSNHawaiianEye.com or RetinaMeeting.com.