Canaloplasty With Intraoperative Low Dosage Mitomycin C

Barnebey, Howard S.

doi:10.1097/ijg.0b013e31824083fb

Cited by 13 publications

(11 citation statements)

References 18 publications

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“…One of the relevant complications in analysis was hypotony in the early and intermediate postoperative phase. The low incidence in our CP study group is in accordance to published data that report hypotony after CP without MMC in 9-20% [8,9] or with MMC in 15% [26]. Congruently, the one highly myopic eye in our study with − 7.5 dpt that was persistently hypotonic until the 6th year had stable visual acuity until last follow-up and never showed signs of hypotonic pathologies in the posterior segment, just transient hypotonic calves of the cornea.…”

Section: Discussionsupporting

confidence: 91%

Is canaloplasty with mitomycin c a safe procedure in myopic glaucoma?

Dooling

Lappas

Dietlein

2022

Graefes Arch Clin Exp Ophthalmol

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Purpose Myopic glaucoma patients display a considerable risk of complications following antiglaucomatous filtering surgery, e.g., trabeculectomy. Canaloplasty with mitomycin C may reduce this risk by avoiding massive overfiltration. Methods We performed retrospective analysis of 31 eyes with myopia that underwent canaloplasty modified with mitomycin C in a consecutive single-surgeon case series. Annual data and success rates were analysed. Twenty-three myopic eyes that had received conventional trabeculectomy with mitomycin C were recorded as a comparison. Results The 31 eyes with a follow-up of 40 ± 26 months after canaloplasty had a mean spherical equivalent of − 8.4 ± 4.5 dioptres. Intraocular pressure decreased from 32.3 ± 9.6 mmHg (range: 17 to 58) to 16.8 ± 8.1 mmHg (range: 5 to 44) 1 year after surgery (− 46%; p < 0.001) with a medication score reduction from 5 to 1.2 (p < 0.001). Qualified success rates (Criterion B: no revision surgery, IOP < 21 mmHg, IOP reduction > 20%) were 83% after 1 year and 61% at the 2nd and 3rd years. In 5 eyes (16%), early ocular hypotony (≤ 5 mmHg) was observed. Two eyes (7%) showed transient choroidal detachment and swelling. The 23 eyes that had received trabeculectomy had success rates (Criterion B) of 91% at the 1st and 86% at the 2nd and 3rd years. Hypotony occurred in 10 eyes (44%), and 4 eyes (17%) showed choroidal detachment or macular folds. Conclusions Postoperative complications related to overfiltration were less frequent after canaloplasty with mitomycin C. Midterm data proved good efficacy. Pressure reduction, success rates and rates of medication free patients were significantly higher in trabeculectomy compared to modified canaloplasty with mitomycin C.

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Section: Discussionsupporting

confidence: 91%

Is canaloplasty with mitomycin c a safe procedure in myopic glaucoma?

Dooling

Lappas

Dietlein

2022

Graefes Arch Clin Exp Ophthalmol

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“…Although both methods achieved significant reduction in IOP and visual improvement after 1 year, a greater percentage of IOP decrease was seen after phacotrabeculectomy. Recently, Barnebey () studied the adjunctive use of MMC during canaloplasty to maintain the intrascleral lake and reported a good IOP reduction to 13.4 ± 4.3 mmHg without additional medication after 12 months. Complications were comparable to canaloplasty without adjunctive MMC.…”

Section: Discussionmentioning

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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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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“…In addition, previous studies have addressed a good safety profile for the technique in open‐angle glaucoma patients. 33 , 34 However, a question has raised: Will a non‐penetrating surgery provide acceptable long‐term control of glaucoma for Radius‐Maumenee syndrome? These patients may gain more advantages from a filtrating approach regarding the level of IOP reduction.…”

Section: Discussionmentioning

confidence: 99%

Radius‐Maumenee syndrome: A case series with a long‐term follow‐up

Elksne

Steiner

Hohensinn

et al. 2023

Clinical Case Reports

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The aim of the case series is to highlight the surgical challenges experienced like failed intervention, choroidal effusion, a postoperative cystoid macular oedema, and describe treatment options for Radius‐Maumenee syndrome. Authors reported on 3 bilateral cases of Radius‐Maumenee syndrome which underwent medical treatment, trabeculectomy with Mitomycin C, implantation with XEN45, Ahmed glaucoma valve, Baerveldt glaucoma implant, and cyclophotocoagulation.

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Canaloplasty With Intraoperative Low Dosage Mitomycin C

Abstract: The adjunctive use of MMC in canaloplasty is safe and effective.

Cited by 13 publications

References 18 publications

Is canaloplasty with mitomycin c a safe procedure in myopic glaucoma?

Is canaloplasty with mitomycin c a safe procedure in myopic glaucoma?

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

Radius‐Maumenee syndrome: A case series with a long‐term follow‐up

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