Ab-Externo Canaloplasty With And Without Suture In Highly Myopic Eyes

To evaluate the effectiveness of ab-externo canaloplasty using the iTrack canaloplasty microcatheter (Nova Eye Medical, Fremont, California), with or without suture, performed as a standalone procedure or in combination with phacoemulsification in glaucoma patients with high myopia. 

Prospective, single-center, single-surgeon study at the Begitek Clínica Oftalmológica, Donostia

This was a prospective, single-center, single-surgeon, observational, non-comparative study with 24-month follow-up comparing the outcomes of ab-externo canaloplasty performed with a tensioning suture (suture group) and without a tensioning suture (no-suture group) in mild to severe glaucoma patients with high myopia. Primary efficacy endpoints included intraocular pressure (IOP) and the number of glaucoma medications at baseline, 12, and 24 months after surgery. Safety was assessed based on reported complications and adverse events.

Forty-seven (47) eyes of 40 patients with a mean age of 62.2±12.6 years, distributed to 33 eyes in the no-suture group and 14 eyes in the suture group. All eyes demonstrated a significant reduction in IOP 24 months postoperatively, from 23.7±7.9 to 15.5±5.0 mmHg in the suture group and from 23.3±7.2 to 18.1±4.1 mmHg in the no-suture group. The mean number of anti-glaucoma medications reduced from 3.0±0.6 to 0.3±0.6 in the suture group and 3.3±1.0 to and 0.4±0.9 in the no-suture group at 24 months. There were no statistically significant differences (p>0.05) in the reduction in IOP and number of medications between the two groups. No serious complications were reported.

Ab-externo canaloplasty performed either with or without a tensioning suture demonstrated good effectiveness in highly myopic eyes with a significant reduction in IOP and number of anti-glaucoma medications. The no-suture modification provides a similar reduction in IOP and medications with reduced tissue handling.