Outcomes of Penetrating Canaloplasty in Childhood Glaucoma

Abstract

Penetrating canaloplasty was safe and effective for the management of refractory childhood glaucoma.Purpose: The purpose of this paper is to report the safety and efficacy of penetrating canaloplasty for the management of childhood glaucoma. Materials and Methods:This single-center prospective interventional case series enrolled 50 eyes of 32 patients with childhood glaucoma between July 2017 and July 2020. Penetrating canaloplasty to create direct communication between the anterior chamber and tensioning suture-dilated the Schlemm canal was performed through a trabecular meshwork ostium in the affected eyes. Preoperative and postoperative intraocular pressure (IOP), number of glaucoma medications, and procedure-related complications were recorded. Qualified and complete success was defined as IOP ≥ 5 and ≤ 21 mm Hg with or without glaucoma medications, respectively.Results: A total of 43 eyes (86.0%) achieved 360 degrees catheterization of Schlemm canal and completed penetrating canaloplasty. The median age at surgery was 5 years (range, 10 d-17 y, mean 6.20 ± 5.46 y). The mean IOP decreased from 33.11 ± 10.89 mm Hg on 2 medications (median, range: 0-5) before surgery to 13.46 ± 4.71 mm Hg on 0 medications (median, range:0-2) postoperatively at 12 months (P < 0.001). Complete and qualified success rates were 81.08% and 89.19%, respectively, at the 12-month follow-up. Hyphema (6/43, 13.95%) and a transient shallow anterior chamber with hypotony (5/43, 11.63%) were the most commonly observed early complications. Conclusion:Penetrating canaloplasty demonstrated good safety and efficacy in eyes with childhood glaucoma, and may be considered an option for managing refractory childhood glaucoma.

Penetrating canaloplasty in angle-closure glaucoma secondary to iridocorneal endothelial syndrome following multiple failed filtering surgeries: A case report

“…[10,11] A small deep sclera helped keep the end of the incision of Schlemm canal open.Professor Liang and his team have reported that PCP demonstrated good safety and efficacy in eyes with primary angle-closure glaucoma, childhood glaucoma and corticosteroid-induced glaucoma. [10,[12][13][14] Here we demonstrated its good safety and efficacy in eyes with angle-closure glaucoma secondary to ICE. PCP could be considered as an option for the treatment of a wide variety of refractory glaucoma.…”

Analysis of research hotspots and trends in pediatric ophthalmopathy based on 10 years of WoSCC literature

“…“Childhood glaucoma,” a prevalent research topic, is characterized by a persistent increase in intraocular pressure, potentially leading to blindness. Surgical treatments for childhood glaucoma are a significant research area, encompassing procedures such as trabeculotomy ( 52 ), combined trabeculotomy-trabeculectomy ( 53 ), angio-atriotomy ( 54 ), Ahmed glaucoma drainage device implantation ( 55 , 56 ), Baerveldt glaucoma drainage device implantation ( 57 ), ciliary body photocoagulation ( 58 ), and XEN gel stent implantation ( 59 ), as well as penetrating otoplasty for refractory cases ( 60 ). Visual outcomes have been correlated with factors such as age at diagnosis, corneal clouding, and the presence of concurrent amblyopia ( 61 , 62 ).…”