Ongoing study finds canaloplasty can significantly reduce IOP

SAN FRANCISCO — A study evaluating the efficacy of canaloplasty found that patients had significant reductions in IOP at 1 year follow-up, according to a surgeon speaking here.

Richard A. Lewis, MD, and colleagues are conducting the ongoing study, which so far has enrolled 145 patients. The patients had a mean baseline IOP of 23.1 mm Hg and were using an average of 1.9 medications.

Dr. Lewis presented the 1-year results for these patients at the American Glaucoma Society's annual meeting.

"Canaloplasty is a nonpenetrating approach to glaucoma surgery that restores the circumferential outflow and physiologic IOP that does not depend on a bleb," he said.

Of the 145 patients, 112 had successful tension suture implantations. In these 112 patients, mean IOP was reduced to 15.4 mm Hg at 3 months postop and to 15.6 mm Hg at 1 year, Dr. Lewis said. Medication use also decreased to an average of 0.3 per patient at 1 year, he noted.

The most common complication was hyphema, which occurred in 4.6% of patients. Three patients needed conversion to trabeculectomy.

Dr. Lewis said the advantages of canaloplasty include that it is a nonpenetrating, nondestructive procedure with easy postop care. It also produces excellent IOP control without requiring a filtering bleb.

However, disadvantages include a steep learning curve, and tension suture placement is key to a successful procedure, he said.