Canaloplasty: Circumferential viscodilation and tensioning of Schlemm's canal using a flexible microcatheter for the treatment of open-angle glaucoma in adults

Lewis, Richard A.; Wolff, Kurt von; Tetz, Manfred; Koerber, Norbert; Kearney, John R.; Shingleton, Bradford J.; Samuelson, Thomas W.

doi:10.1016/j.jcrs.2007.03.051

Cited by 232 publications

(189 citation statements)

References 30 publications

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“…In line with our results, Ayyala et al (2011) observed a more pronounced IOP reduction after 12 months with fewer medications in trabeculectomy (mean 43%) than canaloplasty (mean 32%). Canaloplasty had a better IOP reduction when performed in combination with cataract surgery (Lewis et al 2007(Lewis et al , 2011Shingleton et al 2008;Bull et al 2011;Arthur et al 2013;Tetz et al 2013). …”

Section: Discussionmentioning

confidence: 99%

“…Previous studies comparing non-penetrating with penetrating glaucoma surgeries have reported that although canaloplasty may not be as effective as filtering surgery in lowering IOP without medication, complication rate and risk of serious vision-threatening adverse events are low (Ayyala et al 2011;Brusini & Tosoni 2012;Bruggemann et al 2013;Matlach et al 2013). In addition, the combination of canaloplasty with cataract surgery provides a better IOP reduction than single canaloplasty (Lewis et al 2007(Lewis et al , 2011Shingleton et al 2008;Bull et al 2011;Arthur et al 2013;Tetz et al 2013).…”

Section: Introductionmentioning

confidence: 99%

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Trabeculectomy versus canaloplasty (TVC study) in the treatment of patients with open‐angle glaucoma: a prospective randomized clinical trial

Matlach

Dhillon

Hain

et al. 2015

Acta Ophthalmologica

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ABSTRACT.Purpose: To compare the outcomes of canaloplasty and trabeculectomy in openangle glaucoma. Methods: This prospective, randomized clinical trial included 62 patients who randomly received trabeculectomy (n = 32) or canaloplasty (n = 30) and were followed up prospectively for 2 years. Primary endpoint was complete (without medication) and qualified success (with or without medication) defined as an intraocular pressure (IOP) of ≤18 mmHg (definition 1) or IOP ≤21 mmHg and ≥20% IOP reduction (definition 2), IOP ≥5 mmHg, no vision loss and no further glaucoma surgery. Secondary endpoints were the absolute IOP reduction, visual acuity, medication, complications and second surgeries. Results: Surgical treatment significantly reduced IOP in both groups (p < 0.001). Complete success was achieved in 74.2% and 39.1% (definition 1, p = 0.01), and 67.7% and 39.1% (definition 2, p = 0.04) after 2 years in the trabeculectomy and canaloplasty group, respectively. Mean absolute IOP reduction was 10.8 AE 6.9 mmHg in the trabeculectomy and 9.3 AE 5.7 mmHg in the canaloplasty group after 2 years (p = 0.47). Mean IOP was 11.5 AE 3.4 mmHg in the trabeculectomy and 14.4 AE 4.2 mmHg in the canaloplasty group after 2 years. Following trabeculectomy, complications were more frequent including hypotony (37.5%), choroidal detachment (12.5%) and elevated IOP (25.0%). Conclusions: Trabeculectomy is associated with a stronger IOP reduction and less need for medication at the cost of a higher rate of complications. If target pressure is attainable by moderate IOP reduction, canaloplasty may be considered for its relative ease of postoperative care and lack of complications.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Trabeculectomy versus canaloplasty (TVC study) in the treatment of patients with open‐angle glaucoma: a prospective randomized clinical trial

Matlach

Dhillon

Hain

et al. 2015

Acta Ophthalmologica

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“…Finally, the suture ends are tied outside SC in order to increase SC inner wall/JCT deformation and thereby increase trabecular (conventional) outflow facility. 20,21 Various studies have shown that canaloplasty surgery reduces IOP more than does viscocanalostomy. 22 As a nonpenetrating glaucoma surgery, canaloplasty, like viscocanalostomy, has fewer surgical risks compared to trabeculectomy.…”

Section: Viscocanalostomy and Canaloplastymentioning

confidence: 99%

Application of Canaloplasty in Glaucoma Gene Therapy: Where Are We?

Aktaş

Tian

McDonald

et al. 2014

Journal of Ocular Pharmacology and Therapeutics

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Purpose: Schlemm's canal (SC) inner wall is adjacent to the juxtacanalicular trabecular meshwork (TM) over their entire circumference. We seek to transfer reporter and therapeutic genes to these outflow-modulating tissues via canaloplasty surgery in live monkeys. Methods: A standard canaloplasty surgical approach was performed in cynomolgus monkeys using flexible canaloplasty catheters, modified for monkey eyes with a 175-mm outer diameter and an LED-lighted tip. A 6-0 prolene suture was used for the exact localization of SC. Trypan blue was injected during catheter withdrawal to document catheter placement within SC and to determine ease of injecting fluid into SC. Before, during, and after the injection, the position of the catheter and the anatomic details were video-captured with an externally positioned noncontact endoscopic imaging system and 50 mHz ultrasound biomicroscopy (UBM). Results: A 360°catheterization and injection of dye into SC was achieved. Suture, catheter, and trypan blue were imaged with the endoscope camera system and the catheter was also visualized with UBM. Trypan blue was seen in the SC over 5 clock hours after a 1 clock-hour insertion of the catheter. Conclusions: A modified canaloplasty catheter device might be used for gene delivery to the SC/TM area without circumferential catheterization. Further studies comparing different delivery methods of the vector/ transgene into the SC using canaloplasty are needed.

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“…Surgical approaches to augment suprachoroidal outflow have also been explored with cyclodialysis, suprachoroidal implants, seton devices, and most recently, an ab externo gold shunt placed in the suprachoroidal space. (Pinnas and Boniuk, 1969;Krejci, 1972;Ozdamar et al, 2003;Jordan et al, 2006) Type Glaucoma surgery This chapter, addresses the available knowledge for the novel drainage devices; devices which attempt to assist with flow regulation such as the Ex-PRESS mini-glaucoma shunt (Alcon Laboratories, Inc., Fort Worth, TX) ), Schlemm's canal surgical procedures, including nonpenetrating canaloplasty surgery ( Lewis et al, 2007), the Glaukos trabecular micro-bypass iStent (Nichamin, 2009) the Trabectome microelectrocautery device (Nguyen, 2008) and the suprachoroidal outflow gold microshunt device (GMS) (Melamed et al, 2009) (Table 1).Published data is limited as many of these devices are currently in investigation and undergoing clinical trials.…”

Section: Drainage Devicesmentioning

confidence: 99%

Novel Glaucoma Surgical Devices

Ichhpujani¹,

Moster²

2011

Glaucoma - Basic and Clinical Concepts

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Canaloplasty: Circumferential viscodilation and tensioning of Schlemm's canal using a flexible microcatheter for the treatment of open-angle glaucoma in adults

Abstract: Circumferential viscodilation and tensioning of Schlemm's canal was a safe and effective surgical procedure to reduce IOP in adult patients with OAG.

Cited by 232 publications

References 30 publications

Trabeculectomy versus canaloplasty (TVC study) in the treatment of patients with open‐angle glaucoma: a prospective randomized clinical trial

Trabeculectomy versus canaloplasty (TVC study) in the treatment of patients with open‐angle glaucoma: a prospective randomized clinical trial

Application of Canaloplasty in Glaucoma Gene Therapy: Where Are We?

Novel Glaucoma Surgical Devices

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