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Canaloplasty versus non-penetrating deep sclerectomy – a prospective, randomised study of the safety and efficacy of combined cataract and glaucoma surgery; 12-month follow-up

  • Glaucoma
  • Published:
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Abstract

Purpose

To compare outcomes of phaco-canaloplasty (PC) and phaco-non-penetrating deep sclerectomy (PDS) with a viscoelastic compound.

Methods

This study included 29 eyes after PC and 30 after PDS. Indications were uncontrolled primary open-angle glaucoma (POAG) and a cataract. Corrected distance visual acuity (CDVA), intraocular pressure (IOP), and number of medications were evaluated. Follow-up examinations were performed on days 1 and 7, and after 1, 3, 6, and 12 months. Complete and qualified success was an IOP ≤ 18 mmHg.

Results

At the 12-month follow-up, mean IOP decreased in the PC group from 19.0 ±6.9 mmHg to 12.6 ±2.7 mmHg, and in the PDS group, from 19.1 ±5.8 mmHg to 14.3 ±3.5 mmHg (P < 0.05). Both groups preoperatively and at 12 months showed no significant differences in IOP (P > 0.05). There was no statistically significant difference between the number of medications used (P > 0.05). Complete and qualified success rates for both groups were 79.0 % and 76.9 % (P = 0.701). The most frequent postoperative PC complication was hyphema (58.0 %); for PDS, bleb fibrosis was most frequent (26.7 %). No PC patients required postoperative management. PDS patients required postoperative interventions 58.7 % of the time, including a 5-fluorouracil (5-FU) injection (58.7 %), suture lysis (48.3 %), and needling (27.6 %).

Conclusions

Both PC and PDS lead to an effective decrease in IOP on a short-term follow-up basis and demonstrate similar efficacy and safety profiles. PDS patients required additional procedures including 5-FU injections, suture lysis, or needling. PC patients required no additional procedures.

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Acknowledgments

The authors have no proprietary interest in any of the materials, products, or methods mentioned in this article. No financial support was received for this submission. This paper was presented in part at the 5th World Glaucoma Congress in Vancouver.

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Authors and Affiliations

  1. Department of Ophthalmology, Military Institute of Medicine, Szaserów 128 STR., 04-141, Warsaw, Poland

    Marek Rękas, Anna Byszewska, Katarzyna Petz & Joanna Wierzbowska

  2. Department of Ophthalmology, University Hospital Rostock, Doberaner Straße 140, 18057, Rostock, Germany

    Anselm Jünemann

  3. 63 Karol Szymanowski St., 05-270, Marki, Poland

    Marek Rękas

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  1. Marek Rękas
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  2. Anna Byszewska
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Correspondence to Marek Rękas.

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Rękas, M., Byszewska, A., Petz, K. et al. Canaloplasty versus non-penetrating deep sclerectomy – a prospective, randomised study of the safety and efficacy of combined cataract and glaucoma surgery; 12-month follow-up. Graefes Arch Clin Exp Ophthalmol 253, 591–599 (2015). https://doi.org/10.1007/s00417-015-2931-4

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