Outcome of viscodilation and tensioning of Schlemm’s canal for uveitic glaucoma

Abstract

ObjectiveTo evaluate the safety and efficacy of circumferential viscodilation and tensioning of Schlemm’s canal (canaloplasty) in the treatment of uveitic glaucoma (UG). DesignPilot, retrospective, noncomparative case series. ParticipantsNineteen uveitic eyes of 15 patients with UG. MethodsThe main outcome measure was surgical success. Secondary outcome measures included intraocular pressure, usage of ocular hypotensive medication, visual acuity, and sight-threatening complications. Patients were included when UG could not be controlled despite maximum tolerated medical therapy. Exclusion criteria were peripheral anterior synechiae and previous glaucoma surgery. ResultsMean follow-up time from canaloplasty was 2.6 ± 1.1 years. Mean intraocular pressure decreased from 30.4 ± 8.4 mm Hg preoperatively to 13.8 ± 5.0 mm Hg at last follow-up (p < 0.001). The mean number of ocular hypotensive medications decreased from 3.7 ± 0.8 preoperatively to 0.4 ± 1.0 at last follow-up (p < 0.001). At last follow-up, the complete success, qualified success, and failure rates were 73.7%, 10.5%, and 15.8%, respectively. No canaloplasty-related permanent sight-reducing complications occurred. Preoperative best corrected visual acuity decreased more than 1 Snellen line in 1 eye due to exacerbation of uveitis 18 months postoperatively. ConclusionsCanaloplasty appears to be a relatively safe and effective initial surgical intervention in UG.