Citation:Hu JJ,Lin HS,Zhang SD,Ye WQ,Gu J,Xie YQ,Tang YH,Liang YB.A new bleb-independent surgery namely penetrating canaloplasty for corticosteroid-induced glaucoma: a prospective case series.Int J Ophthalmol 2022;15(7):1077-1081,doi:10.18240/ijo.2022.07.06
A new bleb-independent surgery namely penetrating canaloplasty for corticosteroid-induced glaucoma: a prospective case series
Received:May 26, 2021  Revised:January 26, 2022
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DOI:10.18240/ijo.2022.07.06
Key Words:penetrating canaloplasty  corticosteroid-induced glaucoma  intraocular pressure  bleb-independent filtering surgery
Fund Project:Supported by National Key Research and Development Project of China (No.2020YFC2008200); Program for Zhejiang Leading Talent of S&T Innovation (No.2021R52012); Key Research and Development Projects of Zhejiang Province (No.2022C03112); Zhejiang Provincial Program for the Cultivation of Leading Talents in Colleges and Universities (No.2020099).
                       
AuthorInstitution
Jing-Jing Hu The Eye Hospital, School of Ophthalmology & Optometry, Wenzhou Medical University, Wenzhou , Zhejiang Province, China
Hai-Shuang Lin The Eye Hospital, School of Ophthalmology & Optometry, Wenzhou Medical University, Wenzhou , Zhejiang Province, China
Shao-Dan Zhang The Eye Hospital, School of Ophthalmology & Optometry, Wenzhou Medical University, Wenzhou , Zhejiang Province, China; Glaucoma Institute, Wenzhou Medical University, Wenzhou , Zhejiang Province, China
Wen-Qing Ye The Eye Hospital, School of Ophthalmology & Optometry, Wenzhou Medical University, Wenzhou , Zhejiang Province, China
Juan Gu The Eye Hospital, School of Ophthalmology & Optometry, Wenzhou Medical University, Wenzhou , Zhejiang Province, China
Yan-Qian Xie The Eye Hospital, School of Ophthalmology & Optometry, Wenzhou Medical University, Wenzhou , Zhejiang Province, China
Yi-Hua Tang The Eye Hospital, School of Ophthalmology & Optometry, Wenzhou Medical University, Wenzhou , Zhejiang Province, China
Yuan-Bo Liang The Eye Hospital, School of Ophthalmology & Optometry, Wenzhou Medical University, Wenzhou , Zhejiang Province, China; Glaucoma Institute, Wenzhou Medical University, Wenzhou , Zhejiang Province, China
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Abstract:
      AIM: To report the outcomes of penetrating canaloplasty for corticosteroid-induced glaucoma in a case series.

    METHODS: Penetrating canaloplasty is a bleb-independent filtering surgery unifying canaloplasty and trabeculectomy. In this study, the surgery was performed to restore the natural outflow through surgically expanded Schlemm’s canal and generated trabeculum ostium. A total of 10 eyes of 8 patients were treated with penetrating canaloplasty for corticosteroid-induced glaucoma. Intraocular pressure (IOP) and the number of glaucoma medications at postoperative 3, 6, 12, 18, 24, 36, and 48mo were documented as primary endpoint. Complications after the surgery were recorded as secondary endpoint.

    RESULTS: Penetrating canaloplasty was accomplished successfully for all 10 eyes, with a mean follow-up of 20.4±13.0mo (range 6-48mo). The mean preoperative IOP and number of anti-glaucoma medications were 45.1±6.5 mm Hg and 3.3±0.5 respectively. The mean post-operative IOP at 3, 6, 12, 18, 24, 36, and 48mo were 15.8±6.0, 14.7±3.3, 15.3±2.0, 15.6±2.6, 17.5±1.8, 16.5±4.9, and 14.0 mm Hg. The number of anti-glaucoma medications at these time points were all 0. This surgery failed to control the IOP in 1 eye at 1mo after surgery. Hyphaema occurred in 3 eyes on the first day after surgery. Postoperative transient IOP increasing was encountered with in two eyes from 1wk to 1mo after surgery. Choroidal detachment developed in one eye but responded well to conservative treatment.

    CONCLUSION: Penetrating canaloplasty is effective for corticosteroid-induced glaucoma without serious complications, making it a viable or preferred alternative option.

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