Long-Term Outcome after Canaloplasty and Phacocanaloplasty in Primary Open-Angle Glaucoma.

Abstract

Canaloplasty and phacocanaloplasty achieve a statistically significant IOP-reduction for up to 11 years and decrease the long-term need for glaucoma medications. Both procedures have a low long-term complication rate. To evaluate the long-term outcome of canaloplasty with and without cataract surgery in primary open-angle glaucoma (POAG) patients. 48 eyes of 34 patients with POAG who successfully received canaloplasty alone (group A, n=28) or with phacoemulsification (group B, n=20) were retrospectively analyzed. Demographic data, intraocular pressure (IOP) and IOP-lowering medication were recorded pre- and post-surgery with a follow-up of up to 14 years. The mean follow-up time in group A was 91.4±45.0 months. Mean IOP dropped from 22.0±3.8mmHg at baseline to 14.0±3.3mmHg, 14.3±3.1mmHg, 14.4±3.8mmHg and 16.5±1.2mmHg at 1, 4, 7, 10 years, respectively. IOP-lowering medication count decreased from 1.5±1.0 at baseline to 0.1±0.4, 0.3±0.6, 0.6±0.9 and 0.9±1.1 at 1, 4, 7, 10 years, respectively. The mean follow-up time in group B was 109.1±25.7 months. Mean IOP dropped from 24.5±6.0mmHg at baseline to 13.8±2.9mmHg, 14.9±3.6mmHg, 15.3±2.9mmHg and 14.8±2.0mmHg at 1, 4, 7, 10 years, respectively. IOP-lowering medication count decreased from 2.2±1.2 before surgery to 0.0, 0.1±0.3, 0.1±0.2 and 0.5±0.9 at 1, 4, 7, 10 years, respectively. Canaloplasty and phacocanaloplasty achieved a comparable decrease in IOP and glaucoma medication count with a low complication rate. Both procedures showed a high long-term success rate.