Evaluating the Long-term Success and Safety of Canaloplasty in Glaucoma Patients

BACKGROUND: The aim of this study was to evaluate the long-term treatment success and safety of ab externo canaloplasty in glaucoma patients.

METHODS AND MATERIAL: This study included 44 eyes undergoing canaloplasty. Patients were followed up at 2, 6, 12 months, 3 years and 5 years.

RESULTS: The preoperative intraocular pressure (IOP) was 23.6 ± 6.4 mmHg and was reduced to 15.8 ± 4.5 mmHg at 12 months, 15.6 ± 3.8 mmHg at 3 years and 14.9 ± 3.9 mmHg at 5 years after canaloplasty (p < 0.0001). The relative IOP reduction was 33.6 ± 17.6% after 12 months, 30.4 ± 22.7% after 3 years and 35.1 ± 17.7% after 5 years. Topical glaucoma medications were reduced from 3.0 ± 1.3 to 1.2 ± 1.3 at 12 months, 1.3 ± 1.4 at 3 years and 1.2 ± 1.3 at 5 years (p < 0.0001). The complete surgical success rate (without topical glaucoma medications) was 32.3%, 26.9%, and 20.0% after 5 years for IOP < 21 mmHg, < 18 mmHg, and < 16 mmHg, respectively. The qualified surgical success (with topical glaucoma medications) was 72.0%, 65.8%, and 43.1%, respectively. Six patients underwent 360° trabeculotomy and five patients received laser Descemet puncture during the first 6 months after surgery.

CONCLUSION: Canaloplasty is a safe and effective procedure to achieve a significant reduction in IOP and glaucoma medications up to 5 years after surgery. Greater SC widths were associated with lower IOP values.