Canaloplasty procedure shows promise for OAG in European study

LONDON — A new canaloplasty procedure is showing better pressure-lowering efficacy over viscocanalostomy for open-angle glaucoma, according to a surgeon speaking here.

In canaloplasty, a microcatheter manufactured by iScience is passed into and around Schlemm's canal. Viscoelastic is then injected through the microcatheter to dilate the canal. A suture is attached to the catheter and retracted through the canal, and the two ends are tied together, leaving slight tension on the canal.

Manfred Tetz, MD, presented the 6-month results of a multicenter European study involving 65 patients at the European Society of Cataract and Refractive Surgeons annual meeting.

In the study, patients had a preoperative IOP of 21.9 mm Hg and used an average of two medications. At 6 months' follow-up, mean IOP decreased 37% to 13.8 mm Hg, he said.

Dr. Tetz also reviewed his own results from his first 20 patients, nine of whom underwent canaloplasty in combination with cataract surgery. At 6 months' postop, patients had a mean IOP of 13.7 mm Hg, he said.

"Comparing this to our previous viscocanalostomy data, we were about 3 mm Hg on average lower" with canaloplasty, Dr. Tetz said.

Dr. Tetz noted the procedure involves a learning curve. In combined U.S. and European data for 188 patients with no previous surgery, 89.4% were successfully catheterized. But if the first 10 cases by each surgeon are excluded, 100% of eyes were successfully treated, he said.