Outcomes of Penetrating Canaloplasty in Childhood Glaucoma.

Abstract

Penetrating canaloplasty was safe and effective for the management of refractory childhood glaucoma. The purpose of this paper is to report the safety and efficacy of penetrating canaloplasty for the management of childhood glaucoma. This single-center prospective interventional case series enrolled 50 eyes of 32 patients with childhood glaucoma between July 2017 and July 2020. Penetrating canaloplasty to create direct communication between the anterior chamber and tensioning suture-dilated the Schlemm canal was performed through a trabecular meshwork ostium in the affected eyes. Preoperative and postoperative intraocular pressure (IOP), number of glaucoma medications, and procedure-related complications were recorded. Qualified and complete success was defined as IOP≥5 and ≤21mmHg with or without glaucoma medications, respectively. A total of 43 eyes (86.0%) achieved 360 degrees catheterization of Schlemm canal and completed penetrating canaloplasty. The median age at surgery was 5 years (range, 10d-17y, mean 6.20±5.46y). The mean IOP decreased from 33.11±10.89mmHg on 2 medications (median, range: 0-5) before surgery to 13.46±4.71mmHg on 0 medications (median, range:0-2) postoperatively at 12 months ( P <0.001). Complete and qualified success rates were 81.08% and 89.19%, respectively, at the 12-month follow-up. Hyphema (6/43, 13.95%) and a transient shallow anterior chamber with hypotony (5/43, 11.63%) were the most commonly observed early complications. Penetrating canaloplasty demonstrated good safety and efficacy in eyes with childhood glaucoma, and may be considered an option for managing refractory childhood glaucoma.