Canaloplasty in patients with uveitic glaucoma: a pilot study.

Abstract

Glaucoma is a common vision-threatening complication of uveitis. We investigated the outcome of canaloplasty in patients with chronic uveitis and uncontrolled secondary glaucoma. This was a retrospective study of 12 patients with medically uncontrolled secondary glaucoma who underwent canaloplasty (14 treated eyes), with follow-up of ≥ 24months. The primary outcome measure was complete and qualified (requirement for anti-glaucomatous medication) surgical success rates, as determined by a reduction in intraocular pressure (IOP) and the need for anti-glaucomatous medication. Secondary outcome measures were uveitis activity, best-corrected visual acuity (BCVA), vision-threatening complications, and secondary glaucoma surgery. Canaloplasty resulted in a significant IOP reduction, from a mean preoperative baseline level of 27.1 ± 12.3mmHg to a mean of 14.5 ± 4.3mmHg (p = 0.01) at 24months. Complete success (limit of 15mmHg) was achieved in six patients and qualified success in one patient. However, failure was noted in five patients, two of whom required additional glaucoma surgery. Topical anti-glaucomatous medications were reduced from 2.7 ± 1.2 (mean ± SD) at baseline to 0.6 ± 1.2 at 24months (p = 0.007). Uveitis activity did not increase after surgery. BCVA was not reduced; cataract progressed in two patients. At 2-year follow-up, overall success rate was 58% (IOP ≤ 15 with or without medication), and surgery failed in 5 eyes, 2 eyes requiring additional glaucoma surgery. No harmful complications or worsening of uveitis activity were noted.