Non-penetrating canaloplasty may offer safe alternative to trabeculectomy in POAG

San Francisco- Non-penetrating canaloplasty may provide an effective and safe alternative to standard trabeculectomy in patients with primary open-angle glaucoma (POAG), according to Diamond Y. Tam, MD, University of Toronto.

"[Although] trabeculectomy long has been considered the gold standard for surgical IOP control, it has an extensive short- and long-term risk profile that we’re all familiar with," Dr. Tam said. "So new procedures have been sought that might improve upon that risk profile while maintaining fairly good IOP control."

Dr. Tam and colleagues conducted a retrospective chart review of 25 patients with POAG who underwent either canaloplasty or trabeculectomy. This consecutive case series study was non-randomized. Patients who underwent trabeculectomy received adjunctive intraoperative mitomycin C. Visual acuity, IOP, and number of glaucoma medications were recorded preoperatively and at 6 months and 1 year postoperatively.

Both procedures were effective at reducing IOP and the number of topical glaucoma medications being taken by patients. In patients who underwent trabeculectomy, IOP was reduced from a mean of 25.7 to 10.5 mm Hg (p p

"Non-penetrating canalopasty was not significantly different from trabeculectomy at 1-year follow-up in terms of IOP or medication usage," Dr. Tam said. "Complications and adjunctive procedures were similar, and the two cases of hypotony were both in the trabeculectomy group."

In the search for safer alternative surgical therapies to trabeculectomy, the lack of any cases of hypotony in the canaloplasty group is significant, he concluded.