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Exit strategies in canaloplasty: intraoperative conversion into 180-degree trabeculotomy or 360-degree trabeculotomy in cases of unsuccessful catheterisation of Schlemm’s canal: influence of degree of canal cleavage

  • Glaucoma
  • Published:
Graefe's Archive for Clinical and Experimental Ophthalmology Aims and scope Submit manuscript

Abstract

Purpose

To investigate the safety and efficacy of intraoperative conversion of unsuccessful canaloplasty technique into 180-degree metal or 360-degree suture trabeculotomy.

Methods

In this retrospective observational case series, 35 eyes of 35 patients with open-angle glaucoma (OAG) who had undergone unsuccessful canaloplasty technique and underwent intraoperative conversion were studied. In 17 eyes (group A), the procedure was converted into 180-degree metal trabeculotomy because of unsuccessful circumferential Schlemm’s canal (SC) catheterisation. Group B included 18 eyes that were converted into 360-degree trabeculotomy because of cheese wiring of tension suture through the trabecular meshwork (TM) after successful complete catheterisation of SC.

Results

Median preoperative IOP was 22.0 mmHg (range 16–34) in group A, and 22.0 mmHg (range 15–48) in group B. Median IOP was significantly reduced in both groups postoperatively, at the 12-month examination to 15.0 mmHg (range 9–21) representing a reduction of 36 % in group A, and to 14.5 mmHg (range 8-21) representing a reduction of 34 % in group B. Median glaucoma medication number decreased significantly from 4 (range 2–4) and 3 (range 1–4) preoperatively to 2 (range 0–4) and 1 (range 0–3) at 12 months in groups A and B respectively. Hyphema was the commonest complication, with an incidence of 76 % in group A and 78 % in group B.

Conclusion

180-degree metal or 360-degree suture/catheter trabeculotomy are safe and effective surgical backup methods to control IOP in cases of unsuccessful intracanalicular placement of tension suture during canaloplasty surgery.

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Conflicts of interest

All authors have no affiliations with or involvement in any organization or entity with any financial or non-financial interest in the subject matter or materials discussed in this manuscript.

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Authors and Affiliations

  1. Centre for Ophthalmology, University Hospital Tübingen, Schleichstr. 12-16, 72076, Tübingen, Germany

    Omar Alnahrawy, Focke Ziemssen, Peter Szurman, Martin Alexander Leitritz, Spyridon Dimopoulos & Bogomil Voykov

  2. Institute for Clinical Epidemiology and Applied Biometry, Eberhard Karls University of Tübingen, Tübingen, Germany

    Gunnar Blumenstock

  3. Knappschaft Eye Hospital, Sulzbach, Germany

    Peter Szurman

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  1. Omar Alnahrawy
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  2. Gunnar Blumenstock
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Correspondence to Omar Alnahrawy.

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Alnahrawy, O., Blumenstock, G., Ziemssen, F. et al. Exit strategies in canaloplasty: intraoperative conversion into 180-degree trabeculotomy or 360-degree trabeculotomy in cases of unsuccessful catheterisation of Schlemm’s canal: influence of degree of canal cleavage. Graefes Arch Clin Exp Ophthalmol 253, 779–784 (2015). https://doi.org/10.1007/s00417-015-2955-9

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  • DOI: https://doi.org/10.1007/s00417-015-2955-9

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