Suture-Probe Canaloplasty as an Alternative to Canaloplasty Using the iTrack Microcatheter

PRéCIS:: Significant intraocular pressure (IOP) reduction was achieved using a novel suture-probe canaloplasty (SPCP) procedure in patients with glaucoma. The effect and low rate of surgical complications were comparable with those of iTrack canaloplasty.

Ab externo canaloplasty using the iTrack microcatheter has been established as a safe surgical procedure to treat open-angle glaucoma. This article, however, describes the results of a novel technique using a cost-efficient suture-probe as an alternative to iTrack canaloplasty and presents 12-month follow-up results.

SPCP was performed on 50 eyes of 50 patients with primary open-angle glaucoma, pseudoexfoliation glaucoma, and steroid-induced glaucoma. The mean±SD preoperative IOP was 21.9±7.0 mm Hg. A suture-probe was used to dilate Schlemm canal and to place a trabecular tensioning suture. Postoperative results were noted and statistically analyzed on the day of discharge from the clinic, and at 1.5, 3, 6, and 12 months of follow-up.

In all eyes, the mean postoperative IOP 12 months after SPCP was 13.7±3.0 mm Hg. The number of medications decreased from 2.8±0.9 to 0.1±0.4, and visual acuity was 0.3±0.3 logMAR. Postoperative course and complications included: hyphema >1 mm (2%); microhyphema (4%); bleb leakage (2%); bleb suture (2%); laser goniopuncture (18%); laser suture lysis (4%); scleral flap lifting (4%); and iris incarceration following laser goniopuncture (4%).

SPCP is an inexpensive procedure that can achieve significant IOP reduction in patients with glaucoma. The IOP-lowering effect and low rate of surgical complications were very similar to those of iTrack canaloplasty.