Kanaloplastik und Trabekulektomie im Vergleich

Abstract

Trabeculectomy (TET) is still the gold standard in incisional glaucoma surgery. It achieves an efficient intraocular pressure (IOP) reduction. Unfortunately postsurgical complications of the procedure are frequent. Canaloplasty is a non-penetrating procedure, which aims at restoration of the natural aqueous outflow pathways, without subconjunctival drainage. This study has compared both surgical procedures concerning IOP, defined success criteria, postoperative medication, visual acuity and postoperative complications/interventions. In a retrospective study 22 eyes after trabeculectomy and 22 eyes after canaloplasty were included. IOP, complete and qualified success, postoperative medication, visual acuity and complications/interventions were recorded at 6 month, 12 month and at last follow-up postoperatively. The mean IOP in the trabeculectomy and canaloplasty groups decreased from 23.91 ± 10.68 mmHg to 10.82 ± 3.67 mmHg and from 23.68 ± 7.57 mmHg to 14.50 ± 3.80 mmHg, respectively. The postoperative complications and interventions between the two groups did not reveal a statistically significant difference. Complete success (IOP < 21 mmHg and 20 % IOP reduction from baseline without medication) was achieved in 18 eyes (81.8 %) after trabeculectomy and in 11 eyes (50.0 %) after canaloplasty (p = 0.026). Canaloplasty and trabeculectomy are safe and effective procedures in the treatment of open-angle glaucoma. Both surgical methods reduce the IOP and the postoperative medication to a statistically significant extent. Trabeculectomy attains higher long-term complete success rates accompanied by slightly increased early postoperative complication rates (n. s.), compared to canaloplasty.