Email this article INTRAOCULAR PRESSURE REDUCTION IN OPEN-ANGLE GLAUCOMA AFTER SEGMENTARY DILATION OF SCHLEMM’S CANAL USING IN-HOUSE SECOND GENERATION INTRACANAL EXPANDER
- Authors: Kumar V.1,2, Frolov M.A.2, Dushina G.N.1,2, Bozhok E.V.1, Bezzabotnov A.I.1
-
Affiliations:
- Skhodnya City Hospital
- Peoples’ Friendship University of Russia
- Issue: No 36 (2015)
- Pages: 29-33
- Section: SURGICAL TREATMENT OF OPHTHALMOPATHY
- URL: https://almclinmed.ru/jour/article/view/212
- DOI: https://doi.org/10.18786/2072-0505-2015-36-29-33
- ID: 212
Cite item
Full Text
Abstract
Background: Schlemm’s canal collaps and increased trabecular (especially juxtacalanicular) resistance play an important role in the development of glaucoma. Dilation of Schlemm’s canal and moderate trabecular extension promote restoration of natural aqueous outflow pathways. Previously we had developed first generation Schlemm’s canal expander (SKE-1) and proved its efficacy in decreasing intraocular pressure in open-angle glaucoma. Though, inappropriate size of the expander results in traumatic implantation. Thus, we developed second generation Schlemm’s canal expander (SKE-2) characterized by smaller length and diameter.
Aim: To evaluate effectiveness of SKE-2 in decreasing intraocular pressure in open-angle glaucoma.
Materials and methods: 25 patients (25 eye) were included. 13 patients (13 eyes) in the intervention group underwent glaucoma surgery with SKE-2 implantation. The results were compared with SKE-1 implantation in the control group (12 patients, 12 eyes). The groups were age-, sex and glaucoma stage-matched (p > 0.05). The patients were followed for 1 year. Outcome measures included intraocular pressure changes, complication rate, need for additional hypotensive therapies and repeat surgery.
Results: Intraocular pressure changes, need for additional hypotensive therapies frequency of intra- and postoperative complications didn’t differ between the groups. Trabeculopuncture with yttrium aluminum garnet (YAG) laser as a second step procedure was needed in 2 cases (16%) in the control group and in 5 cases (38%) in the intervention group (p = 0.002).
Conclusion: SKE-1 and SKE-2 are equally effective in reducing intraocular pressure in open-angle glaucoma. Though, after SKE-2 implantation, YAG laser goniopuncture is more frequently needed as a second step procedure.
About the authors
V. Kumar
Skhodnya City Hospital; Peoples’ Friendship University of Russia
Author for correspondence.
Email: kumarvinod1955@gmail.com
MD, PhD, the Head of the Ophthalmic Unit; Professor, Eye Diseases Department
Russian FederationM. A. Frolov
Peoples’ Friendship University of Russia
Email: fake@neicon.ru
MD, PhD, Professor, the Head of the Eye Diseases Department
Russian FederationG. N. Dushina
Skhodnya City Hospital; Peoples’ Friendship University of Russia
Email: fake@neicon.ru
MD, Ophthalmic Unit; Fellow, Eye Diseases Department
Russian FederationE. V. Bozhok
Skhodnya City Hospital
Email: fake@neicon.ru
MD, Ophthalmic Unit
Russian FederationA. I. Bezzabotnov
Skhodnya City Hospital
Email: fake@neicon.ru
MD, Ophthalmic Unit
Russian FederationReferences
- Stegmann R, Pienaar A, Miller D. Viscocanalostomy for open-angle glaucoma in black African patients. J Cataract Refract Surg. 1999;25(3):316–22.
- Lewis RA, von Wolff K, Tetz M, Koerber N, Kearney JR, Shingleton BJ, Samuelson TW. Canaloplasty: circumferential viscodilation and tensioning of Schlemm canal using a flexible microcatheter for the treatment of open-angle glaucoma in adults: two-year interim clinical study results. J Cataract Refract Surg. 2009;35(5):814–24.
- Vandewalle E, Zeyen T, Stalmans I. The iStent trabecular micro-bypass stent: a case series. Bull Soc Belge Ophtalmol. 2009;(311): 23–9.
- Grieshaber MC, Pienaar A, Olivier J, Stegmann R. Canaloplasty for primary openangle glaucoma: long-term outcome. Br J Ophthalmol. 2010;94(11):1478–82.
- Belovay GW, Naqi A, Chan BJ, Rateb M, Ahmed II. Using multiple trabecular microbypass stents in cataract patients to treat open-angle glaucoma. J Cataract Refract Surg. 2012;38(11):1911–7.
- Saheb H, Ahmed II. Micro-invasive glaucoma surgery: current perspectives and future directions. Curr Opin Ophthalmol.
- ;23(2):96–104.
- Arriola-Villalobos P, Martinez-de-la-Casa JM, Diaz-Valle D, Garcia-Vidal SE, Fernandez-Perez C, Garcia-Sanchez J, Garcia-Feijoo J. Mid-term evaluation of the new Glaukos iStent with phacoemulsification in coexistent open-angle glaucoma or ocular hypertension and cataract. Br J Ophthalmol. 2013;97(10):1250–5.
- Kumar V, Frolov MA, Bozhok EV, Dushina GN, Bezzabotnov AI. A new stainless steel spiral schlemm’s canal expander in surgical treatment open-angle glaucoma. Национальный журнал глаукома [Natsional’nyy zhurnal glaukoma]. 2014;13(3):43–51.
- Grant WM. Experimental aqueous perfusion in enucleated human eyes. Arch Ophthalmol. 1963;69:783–801.
- Johnson DH, Johnson M. How does nonpenetrating glaucoma surgery work? Aqueous outflow resistance and glaucoma surgery. J Glaucoma. 2001;10(1):55–67.
- Grieshaber MC, Pienaar A, Olivier J, Stegmann R. Clinical evaluation of the aqueous outflow system in primary open-angle glaucoma for canaloplasty. Invest Ophthalmol Vis Sci. 2010;51(3):1498–504.
- Fujita K, Kitagawa K, Ueta Y, Nakamura T, Miyakoshi A, Hayashi A. Short-term results of canaloplasty surgery for primary open-angle glaucoma in Japanese patients. Case Rep Ophthalmol. 2011;2(1):65–8.
- Shaarawy TM, Sherwood MB, Grehn F, editors. Guidelines on design and reporting of glaucoma surgical trials. World Glaucoma
- Association. Amsterdam: Kugler publications; 2008, 2009. 83 p.
- Краснов ММ. Микрохирургия глауком. М.:Медицина; 1980. 248 c.(Krasnov MM. Microsurgery of glaucoma. Moscow: Meditsina; 1980. 248 p. Russian).
Supplementary files
