Long-Term Outcome After Canaloplasty and Phacocanaloplasty in Primary Open Angle Glaucoma

PRCIS: Canaloplasty and phacocanaloplasty achieve a statistically significant intraocular pressure (IOP)-reduction for up to 11 years and decrease the long-term need for glaucoma medications. Both procedures have a low long-term complication rate.

PURPOSE: To evaluate the long-term outcome of canaloplasty with and without cataract surgery in primary open angle glaucoma (POAG) patients.

PATIENTS AND METHODS: In all, 48 eyes of 34 patients with POAG who successfully received canaloplasty alone (group A, n=28) or with phacoemulsification (group B, n=20) were retrospectively analyzed. Demographic data, IOP, and IOP-lowering medication were recorded presurgery and postsurgery with a follow-up of up to 14 years.

RESULTS: The mean follow-up time in group A was 91.4±45.0 months. Mean IOP dropped from 22.0±3.8 mm Hg at baseline to 14.0±3.3, 14.3±3.1, 14.4±3.8, and 16.5±1.2 mm Hg at 1, 4, 7, and 10 years, respectively. IOP-lowering medication count decreased from 1.5±1.0 at baseline to 0.1±0.4, 0.3±0.6, 0.6±0.9, and 0.9±1.1 at 1, 4, 7, and 10 years, respectively. The mean follow-up time in group B was 109.1±25.7 months. Mean IOP dropped from 24.5±6.0 at baseline to 13.8±2.9, 14.9±3.6, 15.3±2.9, and 14.8±2.0 mm Hg at 1, 4, 7, and 10 years, respectively. IOP-lowering medication count decreased from 2.2±1.2 before surgery to 0.0, 0.1±0.3, 0.1±0.2, and 0.5±0.9 at 1, 4, 7, and 10 years, respectively.

CONCLUSION: Canaloplasty and phacocanaloplasty achieved a comparable decrease in IOP and glaucoma medication count with a low complication rate. Both procedures showed a high long-term success rate.