Achieving Inner Aqueous Drain in Glaucoma Secondary to Iridocorneal Endothelial Syndrome: One Year Results of Penetrating Canaloplasty

Yuxuan Deng; Shaodan Zhang; Wenqing Ye; Juan Gu; Haishuang Lin; Huanhuan Cheng; Yanqian Xie; Rongrong Le; Yan Tao; Wei Zhang; Wei Chen; Clement C Tham; Mingguang He; Ningli Wang; Yuanbo Liang

doi:10.1016/j.ajo.2022.07.006

Achieving Inner Aqueous Drain in Glaucoma Secondary to Iridocorneal Endothelial Syndrome: One Year Results of Penetrating Canaloplasty

Am J Ophthalmol. 2022 Nov:243:83-90. doi: 10.1016/j.ajo.2022.07.006. Epub 2022 Jul 21.

Authors

Affiliations

¹ From National Clinical Research Center for Ocular Diseases, The Eye Hospital of Wenzhou Medical University, Glaucoma Research Institute of Wenzhou Medical University, Zhejiang, China (Y.D, S.Z, W.Y, J.G, H.L, H.C, Y.X, R.L, Y.T, W.C, Y.L);; Qingdao Municipal Hospital, Qingdao, Shandong, China (Y.D);; Wuhu First People's Hospital, Wuhu, Anhui, China (H.C);; Biomedical Informatics and Statistics Center, School of Public Health, Fudan University, Shanghai, China (W.Z);; Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong SAR, China (C.C.T);; Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China (M.H);; Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, Melbourne, Australia (M.H);; Beijing Tongren Hospital, Beijing, China (N.W).
² From National Clinical Research Center for Ocular Diseases, The Eye Hospital of Wenzhou Medical University, Glaucoma Research Institute of Wenzhou Medical University, Zhejiang, China (Y.D, S.Z, W.Y, J.G, H.L, H.C, Y.X, R.L, Y.T, W.C, Y.L);; Qingdao Municipal Hospital, Qingdao, Shandong, China (Y.D);; Wuhu First People's Hospital, Wuhu, Anhui, China (H.C);; Biomedical Informatics and Statistics Center, School of Public Health, Fudan University, Shanghai, China (W.Z);; Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong SAR, China (C.C.T);; Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China (M.H);; Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, Melbourne, Australia (M.H);; Beijing Tongren Hospital, Beijing, China (N.W). Electronic address: yuanboliang@126.com.

PMID: 35870489
DOI: 10.1016/j.ajo.2022.07.006

Abstract

Purposes: To report the efficacy of a bleb-independent penetrating canaloplasty in the management of glaucoma secondary to iridocorneal endothelial syndrome (GS-ICE).

Design: Prospective, non-comparative clinical study.

Methods: Penetrating canaloplasty was performed on 35 eyes from 35 patients with GS-ICE and medically uncontrolled intraocular pressure (IOP) between January 2018 and April 2020. Patients were followed up at 1 week, months 1, 3, 6, 12 postoperatively, and semi-annually thereafter. The IOP, anti-glaucoma medication, and surgery-related complications were recorded. Surgical success was defined as IOP ≥ 5 mmHg and ≤ 21 mmHg without (complete success) or with/without (qualified success) IOP-lowering medication.

Results: A total of 29 eyes (82.9%) had 360° catheterization and successfully received penetrating canaloplasty. Of these eyes, 24 (82.8%) achieved qualified success and 22 (75.9%) achieved qualified success at 12 months after surgery. The mean IOP decreased from 39.5 ± 11.8 mmHg on 2.9 ± 1.0 medications before surgery to 16.6 ± 5.3 mmHg (P < .001) on 0.2 ± 0.6 medications (P < .001) at 12 months postoperatively, respectively. Hyphema (37.9%), transient hypotony (34.5%), and transient postoperative IOP elevation (≥ 30 mmHg, 17.9%) were the most commonly observed early complications at the 1 week and 1 month visits. From 1 month and beyond, all treated eyes showed no obvious bleb at the operation quadrant.

Conclusions: Penetrating canaloplasty rescued the inner aqueous outflow in ICE eyes and demonstrated acceptable success in IOP control with few complications, providing a new option for the management of GS-ICE.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Antiglaucoma Agents
Filtering Surgery* / methods
Glaucoma* / complications
Glaucoma* / surgery
Glaucoma, Open-Angle* / complications
Glaucoma, Open-Angle* / surgery
Humans
Intraocular Pressure
Iridocorneal Endothelial Syndrome* / complications
Iridocorneal Endothelial Syndrome* / diagnosis
Iridocorneal Endothelial Syndrome* / surgery
Prospective Studies
Retrospective Studies
Trabeculectomy* / methods
Treatment Outcome

Substances

Antiglaucoma Agents