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Outcomes of 360° suture trabeculotomy after unsuccessful canaloplasty

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

Abstract

Background

Canaloplasty is a well-established non-penetrating glaucoma surgery. Unsuccessful outcomes can be enhanced by micro-invasive 360° suture trabeculotomy (360°trabeculotomy), analyzed in this study.

Methods

This retrospective study included twenty eyes of 19 patients, mean age 59.7±17.2 years, with primary open-angle glaucoma (POWG n = 14), pseudoexfoliation glaucoma (PEX n = 3), juvenile glaucoma (n = 2) and aphakic glaucoma (n = 1), who underwent micro-invasive 360° trabeculotomy after unsuccessful (intraocular pressure (IOP) >21 mmHg under maximum glaucoma eye drop therapy (Meds)) canaloplasty. IOPs, Meds, complications and failure rates (IOP >21 mmHg at two consecutive follow-ups) were evaluated. Complete success (no Meds) and qualified success (with Meds) rates for IOP levels ≤21 mmHg and ≤ 18 mmHg at the last follow-up were evaluated.

Results

IOPs and Meds were significantly reduced from before to 1 week (10.3±3.1 days) after 360° trabeculotomy (IOP, 28.3±6.0 mmHg to 15.8±4.5 mmHg; p < 0.001; Meds, 3.1 ± 1.2 to 1.0 ± 1.2; p < 0.001). IOPs (p = 0.37) and Meds (p = 0.33) did not decrease further from 1 week until the last follow-up (18.3 ± 8.2 months (IOP, 14.4±3.8 mmHg; Meds, 1.5±1.3)).

Complete and qualified success was 25% (5/20) and 70% (14/20) for IOP ≤21 mmHg, as well as 25% (5/20) and 60% (12/20) for IOP ≤18 mmHg. Four eyes had postoperative hyphema, which resolved after a mean period of 4.0 ± 2.2 days. Five failures occurred after a mean of 40.6 ± 51.9 days after 360° trabeculotomy. All failures underwent trabeculectomy. Eyes that needed early (≤3 months post canaloplasty) 360° trabeculotomy showed higher IOPs before (p < 0.001) and lower (p = 0.03) IOPs 2 months post 360° trabeculotomy than eyes with late (>3 months) 360° trabeculotomy surgery.

Conclusions

360° trabeculotomy is a safe, micro-invasive, simple and successful method to enhance failed canaloplasty.

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References

  1. Grieshaber MC (2012) Ab externo Schlemm's canal surgery: viscocanalostomy and canaloplasty. Dev Ophthalmol 50:109–124. https://doi.org/10.1159/000334793

    Article  PubMed  Google Scholar 

  2. Crandall AS (1999) Nonpenetrating filtering procedures: viscocanalostomy and collagen wick. Semin Ophthalmol 14(3):189–195. https://doi.org/10.3109/08820539909061473

    Article  CAS  Google Scholar 

  3. Brusini P (2014) Canaloplasty in open-angle glaucoma surgery: a four-year follow-up. ScientificWorldJournal 2014:469609. https://doi.org/10.1155/2014/469609

    Article  PubMed  PubMed Central  Google Scholar 

  4. Lewis RA, von Wolff K, Tetz M, Koerber N, Kearney JR, Shingleton BJ, Samuelson TW (2011) Canaloplasty: Three-year results of circumferential viscodilation and tensioning of Schlemm canal using a microcatheter to treat open-angle glaucoma. J Cataract Refract Surg 37(4):682–690. https://doi.org/10.1016/j.jcrs.2010.10.055

    Article  PubMed  Google Scholar 

  5. Khaimi MA, Dvorak JD, Ding K (2017) An Analysis of 3-year outcomes following canaloplasty for the treatment of open-angle glaucoma. J Ophthalmol 2017:2904272. https://doi.org/10.1155/2017/2904272

    Article  PubMed  PubMed Central  Google Scholar 

  6. Bull H, von Wolff K, Korber N, Tetz M (2011) Three-year canaloplasty outcomes for the treatment of open-angle glaucoma: European study results. Graefes Arch Clin Exp Ophthalmol 249(10):1537–1545. https://doi.org/10.1007/s00417-011-1728-3

    Article  PubMed  Google Scholar 

  7. Seuthe AM, Januschowski K, Szurman P (2016) Micro-invasive 360-degree suture trabeculotomy after successful canaloplasty - one year results. Graefes Arch Clin Exp Ophthalmol 254(1):155–159. https://doi.org/10.1007/s00417-015-3192-y

    Article  PubMed  Google Scholar 

  8. Matlach J, Dhillon C, Hain J, Schlunck G, Grehn F, Klink T (2015) Trabeculectomy versus canaloplasty (TVC study) in the treatment of patients with open-angle glaucoma: a prospective randomized clinical trial. Acta Ophthalmol 93(8):753–761. https://doi.org/10.1111/aos.12722

    Article  PubMed  PubMed Central  Google Scholar 

  9. Grieshaber MC, Pienaar A, Olivier J, Stegmann R (2010) Canaloplasty for primary open-angle glaucoma: long-term outcome. Br J Ophthalmol 94(11):1478–1482. https://doi.org/10.1136/bjo.2009.163170

    Article  PubMed  Google Scholar 

  10. Lewis RA, von Wolff K, Tetz M, Korber N, Kearney JR, Shingleton B, Samuelson TW (2007) Canaloplasty: circumferential viscodilation and tensioning of Schlemm's canal using a flexible microcatheter for the treatment of open-angle glaucoma in adults: interim clinical study analysis. J Cataract Refract Surg 33(7):1217–1226. https://doi.org/10.1016/j.jcrs.2007.03.051

    Article  PubMed  Google Scholar 

  11. Shingleton B, Tetz M, Korber N (2008) Circumferential viscodilation and tensioning of Schlemm canal (canaloplasty) with temporal clear corneal phacoemulsification cataract surgery for open-angle glaucoma and visually significant cataract: one-year results. J Cataract Refract Surg 34(3):433–440. https://doi.org/10.1016/j.jcrs.2007.11.029

    Article  PubMed  Google Scholar 

  12. Cagini C, Peruzzi C, Fiore T, Spadea L, Lippera M, Lippera S (2016) Canaloplasty: Current Value in the Management of Glaucoma. J Ophthalmol 2016:7080475. https://doi.org/10.1155/2016/7080475

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  13. Leske MC, Heijl A, Hyman L, Bengtsson B (1999) Early manifest glaucoma trial: design and baseline data. Ophthalmology 106(11):2144–2153. https://doi.org/10.1016/s0161-6420(99)90497-9

    Article  CAS  PubMed  Google Scholar 

  14. Fuest M, Kuerten D, Koch E, Becker J, Hirsch T, Walter P, Plange N (2016) Evaluation of early anatomical changes following canaloplasty with anterior segment spectral-domain optical coherence tomography and ultrasound biomicroscopy. Acta Ophthalmol 94(5):e287–e292. https://doi.org/10.1111/aos.12917

    Article  PubMed  Google Scholar 

  15. Gesser C, Klemm M (2014) Post-surgical treatment after non-penetrating glaucoma surgery: the goniopuncture. Klin Monbl Augenheilkd 231(6):631–635. https://doi.org/10.1055/s-0033-1351060

    Article  CAS  PubMed  Google Scholar 

  16. Grieshaber MC, Fraenkl S, Schoetzau A, Flammer J, Orgul S (2011) Circumferential viscocanalostomy and suture canal distension (canaloplasty) for whites with open-angle glaucoma. J Glaucoma 20(5):298–302. https://doi.org/10.1097/IJG.0b013e3181e3d46e

    Article  PubMed  Google Scholar 

  17. Voykov B, Rohrbach JM (2016) Revision procedures after canaloplasty. Ophthalmologe 113(11):910–913. https://doi.org/10.1007/s00347-016-0314-9

    Article  CAS  PubMed  Google Scholar 

  18. Matlach J, Freiberg FJ, Leippi S, Grehn F, Klink T (2013) Comparison of phacotrabeculectomy versus phacocanaloplasty in the treatment of patients with concomitant cataract and glaucoma. BMC Ophthalmol 13:1. https://doi.org/10.1186/1471-2415-13-1

    Article  PubMed  PubMed Central  Google Scholar 

  19. Matthaei M, Steinberg J, Wiermann A, Richard G, Klemm M (2011) Canaloplasty : a new alternative in non-penetrating glaucoma surgery. Ophthalmologe 108(7):637–643. https://doi.org/10.1007/s00347-010-2305-6

    Article  CAS  PubMed  Google Scholar 

  20. Tam DY, Barnebey HS, Ahmed II (2013) Nd: YAG laser goniopuncture: indications and procedure. J Glaucoma 22(8):620–625. https://doi.org/10.1097/IJG.0b013e31824d512a

    Article  PubMed  Google Scholar 

  21. Ethier CR, Kamm RD, Palaszewski BA, Johnson MC, Richardson TM (1986) Calculations of flow resistance in the juxtacanalicular meshwork. Invest Ophthalmol Vis Sci 27(12):1741–1750

    CAS  PubMed  Google Scholar 

  22. Seiler T, Wollensak J (1985) The resistance of the trabecular meshwork to aqueous humor outflow. Graefes Arch Clin Exp Ophthalmol 223(2):88–91

    Article  CAS  Google Scholar 

  23. Brandao LM, Schotzau A, Grieshaber MC (2015) Suture distension of Schlemm's canal in canaloplasty: an anterior segment imaging study. J Ophthalmol 2015:457605. https://doi.org/10.1155/2015/457605

    Article  PubMed  PubMed Central  Google Scholar 

  24. Grieshaber MC, Schoetzau A, Flammer J, Orgul S (2013) Postoperative microhyphema as a positive prognostic indicator in canaloplasty. Acta Ophthalmol 91(2):151–156. https://doi.org/10.1111/j.1755-3768.2011.02293.x

    Article  CAS  PubMed  Google Scholar 

  25. Koch JM, Heiligenhaus A, Heinz C (2011) Canaloplasty and transient anterior chamber haemorrhage: a prognostic factor? Klin Monbl Augenheilkd 228(5):465–467. https://doi.org/10.1055/s-0029-1245486

    Article  CAS  PubMed  Google Scholar 

  26. Wallin O, Al-ahramy AM, Lundstrom M, Montan P (2014) Endophthalmitis and severe blebitis following trabeculectomy. Epidemiology and risk factors; a single-centre retrospective study. Acta Ophthalmol 92(5):426–431. https://doi.org/10.1111/aos.12257

    Article  PubMed  Google Scholar 

  27. Robert MC, Harasymowycz P (2013) Hemorrhagic descemet detachment after combined canaloplasty and cataract surgery. Cornea 32(5):712–713. https://doi.org/10.1097/ICO.0b013e318281af48

    Article  PubMed  Google Scholar 

  28. Grieshaber MC, Pienaar A, Olivier J, Stegmann R (2010) Comparing two tensioning suture sizes for 360 degrees viscocanalostomy (canaloplasty): a randomised controlled trial. Eye (Lond) 24(7):1220–1226. https://doi.org/10.1038/eye.2009.317

    Article  CAS  Google Scholar 

  29. Sihota R, Angmo D, Ramaswamy D, Dada T (2018) Simplifying "target" intraocular pressure for different stages of primary open-angle glaucoma and primary angle-closure glaucoma. Indian J Ophthalmol 66(4):495–505. https://doi.org/10.4103/ijo.IJO_1130_17

    Article  PubMed  PubMed Central  Google Scholar 

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Authors and Affiliations

  1. Department of Ophthalmology, RWTH Aachen University, Pauwelsstr. 30, 52074, Aachen, Germany

    Sabine Baumgarten, David Kürten, Tibor Lohmann, Hannah Schellhase, Niklas Plange, Peter Walter & Matthias Fuest

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  1. Sabine Baumgarten
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  2. David Kürten
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Correspondence to Matthias Fuest.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee (Medical Ethical Review Board, University RWTH Aachen) and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Baumgarten, S., Kürten, D., Lohmann, T. et al. Outcomes of 360° suture trabeculotomy after unsuccessful canaloplasty. Graefes Arch Clin Exp Ophthalmol 258, 387–393 (2020). https://doi.org/10.1007/s00417-019-04545-2

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