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Ab-externo canaloplasty with and without suture in highly myopic eyes

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Abstract

Purpose

To evaluate the effectiveness of ab-externo canaloplasty using the iTrack canaloplasty microcatheter (Nova Eye Inc, Fremont, California), with or without suture, in glaucoma patients with high myopia.

Methods

This was a prospective, single-center, single-surgeon, observational study comparing the outcomes of ab-externo canaloplasty performed with a tensioning suture (suture group) and without a tensioning suture (no-suture group) in mild to severe glaucoma patients with high myopia. Twenty-three eyes received canaloplasty as a standalone procedure, 5 in combination with phacoemulsification. Primary efficacy endpoints included intraocular pressure (IOP) and the number of glaucoma medications. Safety was assessed based on reported complications and adverse events.

Results

Twenty-nine eyes of 29 patients with a mean age of 61.2 ± 12.3 years; 19 eyes in the no-suture group and 10 eyes in the suture group. All eyes demonstrated a significant reduction in IOP 24 months postoperatively, from 21.9 ± 7.22 to 15.4 ± 4.86 mmHg in the suture group and from 23.8 ± 7.58 to 19.7 ± 3.68 mmHg in the no-suture group. The mean number of anti-glaucoma medications reduced from 3.1 ± 0.6 to 0.4 ± 0.7 in the suture group and 3.3 ± 0.9 to and 0.2 ± 0.6 in the no-suture group at 24 months. IOP was not significantly different at baseline between the 2 groups, but it was statistically different at 12 and 24 months. There was no statistically significant difference in the number of medications between the groups at baseline, 12 and 24 months. No serious complications were reported.

Conclusion

Ab-externo canaloplasty performed either with or without a tensioning suture demonstrated good effectiveness in highly myopic eyes with a significant reduction in IOP and number of anti-glaucoma medications. The suture group achieved a lower postoperative IOP. However, the no-suture modification provides a similar reduction in medications with reduced tissue handling.

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Acknowledgements

Medical writing assistance was provided by GP Communications, funded by Nova Eye Medical.

Funding

The authors have no financial or proprietary interest in any material or method mentioned.

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Authors and Affiliations

  1. Begitek Clínica Oftalmológica - Miranza, Pz. Teresa de Calcuta, 7, 20012, Donostia-San Sebastian, Spain

    Javier Aritz Urcola, Igor Illarramendi & Gorka Lauzirika

  2. Hospital Universitario Araba, Vitoria-Gasteiz, Spain

    Javier Aritz Urcola

  3. University of the Basque Country, Leioa, Spain

    Javier Aritz Urcola

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  1. Javier Aritz Urcola
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  3. Gorka Lauzirika
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Contributions

Dr JU conceived the idea, and along with Dr. II and Dr GL they have gathered the data. Initial research was done by Dr JU and Dr II. The draft of the paper was written by Dr. II and was amended by Dr JU and Dr GL. Dr. JU and Dr GL have created the tables and figures. All authors have been involved in the critical revision of the paper, and all have provided their approval for the submission of the manuscript for peer review.

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Correspondence to Javier Aritz Urcola.

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Urcola, J.A., Illarramendi, I. & Lauzirika, G. Ab-externo canaloplasty with and without suture in highly myopic eyes. Int Ophthalmol 43, 3695–3705 (2023). https://doi.org/10.1007/s10792-023-02779-y

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