Canaloplasty with the Stegmann Canal expander – two years results
Abstract
Purpose
To assess the safety and efficacy of circumferential viscocanalostomy (canaloplasty) using a new canal expander in Caucasians with primary open-angle glaucoma (POAG).
Methods
Thirty-five eyes of 35 consecutive patients with medically uncontrolled POAG underwent primary canaloplasty and implantation of the Stegmann Canal Expander into Schlemm's canal. Schlemm's canal was unroofed ab externo, and dilated with viscoelastic material and microcatheter. The Stegmann Canal Expander was implanted into the canal lumen, and the superficial scleral flap was closed watertight. Laser goniopuncture of the trabeculo-Descemet's membrane window was performed if postoperative intraocular pressure (IOP) exceeded 16 mmHg.
Results
The mean IOP dropped from 26.6 ± 4.2 mm Hg preoperatively to 12.1 ± 2.6 mm Hg at 1 month, 13.1 ± 1.9 mmHg at 6 months, 13.0 ± 1.9 mm Hg at 12 months, and 13.4 ± 2.4 mm Hg at 24 months (p < 0.001). Laser goniopuncture was performed on 5 eyes (14.7%) 6.4 months after surgery; the mean IOP was 19.1 mm Hg before and 14.1 mm Hg after goniopuncture. The number of medications dropped from 2.9 ± 0.3 before surgery to 0.08 ± 0.3 after surgery (p < 0.001). The postoperative BCVA at last visit (0.12 ± 0.09; range, 0–0.39) was comparable to preoperative values (0.16 ± SD 0.10; range, 0–0.39) (p = 0.35). Complications were minor and included microhyphema (14 eyes) and transient elevated IOP (steroid responder; 4 eyes), partial peripheral Descemet's membrane detachment (2 eyes).
Conclusions
Canaloplasty with implantation of the Stegmann Canal Expander reduced IOP significantly in POAG with a low risk for complications.
