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Micro-invasive 360-degree suture trabeculotomy after successful canaloplasty – one year results

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

Abstract

Purpose

This study was conducted to analyse the intraocular pressure (IOP)-lowering and drug-sparing effect of micro-invasive 360-degree suture trabeculotomy after successfully performed canaloplasty.

Methods

This retrospective interventional study included patients with open angle glaucoma or secondary forms of glaucoma, suffering from insufficient IOP level after previously conducted canaloplasty. To enhance the IOP-lowering canaloplasty effect, all patients underwent micro-invasive 360-degree suture trabeculotomy as a conjunctiva-sparing ab interno approach for circumferential trabeculotomy. This was achieved by introducing end-gripping forceps into the anterior chamber with topical anaesthesia, and grasping and extracting the canaloplasty suture through the trabecular meshwork under gonioscopic visualisation. Main outcome measures were IOP reduction and the number of IOP-lowering medications after 3 and 12 moths. Intraoperative and postoperative complications were documented systematically.

Results

In total, 88 eyes of 88 patients were included. Mean IOP reduction after micro-invasive 360-degree suture trabeculotomy at month 3 was 37.5 % (from baseline 22.8 ± 6.7 mmHg to 14.3 ± 3.1 mmHg, p < 0.01) and 41.2 % after 12 months (from 22.8 ± 6.7 mmHg to 13.4 ± 2.3 mmHg, p < 0.01). The number of IOP-lowering medications decreased significantly from a mean of 2.7 ± 1.4 to 1.3 ± 1.4 after 3 months, and 1.6 ± 1.2 after 12 months. No serious complications were observed. However, mild or moderate retrograde bleeding from the collector channels was present in 25 % of eyes that resorbed spontaneously in all cases.

Conclusions

Micro-invasive 360-degree suture trabeculotomy represents a simple and safe minimal invasive ab interno technique to postoperatively enhance the IOP-lowering and drug-sparing effect of canaloplasty.

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Authors and Affiliations

  1. Knappschaft Eye Clinic Sulzbach, Knappschaft Hospital Saar, An der Klinik 10, 66280, Sulzbach, Saar, Germany

    Anna-Maria Seuthe, Kai Januschowski & Peter Szurman

  2. Centre for Ophthalmology, University Eye Clinic Tuebingen, Tuebingen, Germany

    Kai Januschowski & Peter Szurman

Authors
  1. Anna-Maria Seuthe
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  2. Kai Januschowski
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  3. Peter Szurman
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Correspondence to Anna-Maria Seuthe.

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All authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest (such as honoraria; educational grants; participation in speakers’ bureaus; membership, employment, consultancies, stock ownership, or other equity interest; and expert testimony or patent-licensing arrangements), or non-financial interest (such as personal or professional relationships, affiliations, knowledge or beliefs) in the subject matter or materials discussed in this manuscript.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

For this type of study, formal consent was not required.

This article does not contain any studies with animals performed by any of the authors.

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Seuthe, AM., Januschowski, K. & Szurman, P. Micro-invasive 360-degree suture trabeculotomy after successful canaloplasty – one year results. Graefes Arch Clin Exp Ophthalmol 254, 155–159 (2016). https://doi.org/10.1007/s00417-015-3192-y

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  • DOI: https://doi.org/10.1007/s00417-015-3192-y

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