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Transcanalicular Diode Laser-assisted Dacryocystorhinostomy for the Treatment of Primary Acquired Nasolacrimal Duct Obstruction

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Canaloplasty after failed trabeculectomy: a possible option.

Paolo Brusini¹, Claudia Tosoni

¹S. Maria della Misericordia Hospital, Udine, Italy.

Journal of Glaucoma

|December 11, 2012

Summary

Canaloplasty can effectively lower intraocular pressure (IOP) in patients with glaucoma who have previously failed trabeculectomy surgery. This procedure offers a viable alternative for managing refractory glaucoma when Schlemm's canal remains undamaged.

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Transcanalicular Diode Laser-assisted Dacryocystorhinostomy for the Treatment of Primary Acquired Nasolacrimal Duct Obstruction

Transcanalicular Diode Laser-assisted Dacryocystorhinostomy for the Treatment of Primary Acquired Nasolacrimal Duct Obstruction

Published on: October 13, 2017

Area of Science:

Ophthalmology
Glaucoma Surgery
Microsurgery

Background:

Canaloplasty is typically performed on eyes without prior filtering surgery for glaucoma.
Trabeculectomy may spare Schlemm's canal, making it amenable to subsequent canaloplasty.
Elevated intraocular pressure (IOP) despite maximal medical therapy necessitates alternative treatments.

Purpose of the Study:

To evaluate the efficacy and safety of canaloplasty in patients with previously failed trabeculectomy.
To assess IOP reduction and medication usage after canaloplasty in this specific patient group.

Main Methods:

Retrospective analysis of 6 eyes undergoing canaloplasty after failed trabeculectomy.
Preoperative and postoperative IOP measurements and medication counts were recorded.
Surgical outcomes, including successful cannulation and conversion to viscocanalostomy, were documented.

Main Results:

Canaloplasty was successfully completed in 5 out of 6 eyes.
Mean preoperative IOP of 32.2±9.6 mm Hg decreased significantly postoperatively.
Mean IOP at 24 months was 16.3 mm Hg, with a reduction in medication use from 3.2 to 2.3.

Conclusions:

Canaloplasty is a potential surgical option for eyes with failed trabeculectomy, provided Schlemm's canal is intact.
The procedure demonstrates significant IOP-lowering effects and reduces medication dependency in selected glaucoma patients.