Prcis: Deep sclerectomy (DS) and canaloplasty provide better intraocular pressure (IOP) control than viscocanalostomy. DS required less glaucoma medications but more interventions to reach target IOP.
Purpose: To compare real-world outcomes of three non-penetrating glaucoma surgery (NPGS) techniques.
Purpose: Several new implant devices have recently been introduced to glaucoma surgery using various techniques for reducing intraocular pressure (IOP). Two implants introduced during the past couple of years, XEN45 and PreserFlo Microshunt, are both designed to control subconjunctival filtration. There are two Swiss multicenter studies that collected the data retrospectively to analyze the efficacy and safety of these two devices separately.
View Article and Find Full Text PDFGlaucoma is a serious complication after corneal transplantation and itself a common cause for graft failure and leading cause of vision loss post-keratoplasty due to corneal endothelial decompensation. Endothelial keratoplasty procedures like Descemet stripping automated endothelial keratoplasty (DSAEK) and Descemet membrane endothelial keratoplasty (DMEK) may be superior to penetrating keratoplasty (PK) regarding the incidence of elevated intraocular pressure (IOP) and development of glaucoma. There are indications that regardless of the method of keratoplasty, some corneal diseases like pseudophakic bullous keratopathy, corneal perforation, and graft rejection have a higher risk for developing post-keratoplasty glaucoma than keratoconus and corneal dystrophies and likewise respond less to IOP lowering therapy.
View Article and Find Full Text PDFPurpose: To evaluate the correlation between retinal venous blood flow parameters and glaucomatous visual field damage in a retrospective analysis.
Methods: Fifty-five (24 male, 31 female) glaucoma patients, under intraocular pressure (IOP) reducing treatment, aged (mean ± SD) 69 ± 10 years, 29 with primary open-angle and 26 with normal-tension glaucoma, were evaluated with regard to the correlation between IOP, color Doppler retinal venous blood flow velocity and glaucomatous damage.
Results: Univariate regression analysis disclosed statistically significant correlations of the visual field index MD with age, IOP and venous blood flow (p ≤ 0.
Purpose: To compare a modified incision technique with classic scleral flap dissection for canaloplasty with canal expander regarding efficacy and safety.
Methods: In a prospective randomized pilot study of 32 eyes of 16 patients with primary open-angle glaucoma, access to Schlemm's canal was created by deep lamellar dissection (scleral flap excision, group 1) or by vertical cut-down incision (group 2). Following canal opening and viscodilation with microcannula and sodium hyaluronate, two Stegmann Canal Expanders were implanted, and the scleral flap or vertical incision, respectively, was closed watertight.
Intracorneal ring segment (ICRS) implantation represents a modern, minimally invasive, surgical option for visual improvement in patients with keratoconus. ICRS modify the corneal geometry in a manner that enhances its refractive properties and thereby, they improve visual acuity. It is well-documented that implantation of ICRS decreases the keratometric readings, spherical equivalent and cylinder, reduces high-order aberrations and improves uncorrected distance visual acuity (UDVA) and best-corrected distance visual acuity (BCDVA) in patients with keratoconus.
View Article and Find Full Text PDFGraefes Arch Clin Exp Ophthalmol
August 2019
Purpose: To present a modified surgical technique for canaloplasty with the Stegmann Canal Expander obviating the need for lamellar scleral dissection.
Methods: After limbal peritomy of the conjunctiva, the sclera is not dissected in the classic lamellar fashion with superficial and deep scleral flaps but is successively 'scratched' down by radial incision until Schlemm's canal (SC) is opened (trench cut). Following canal opening and viscodilation with a microcannula and sodium hyaluronidate, one Stegmann Canal Expander is implanted on either side of the canal ostia and the scleral incision is closed watertight.
Introduction: The concept of canaloplasty is to increase aqueous egress through all structures that control the aqueous outflow, such as the trabecular meshwork, Schlemm's canal, and collector channels, by viscomodulation and by placing of a suture stent into the canal. Clinical studies show canaloplasty to be safe and efficient in lowering the intraocular pressure; however, proper knotting of the tensioning suture is technically challenging and even impossible if circumferential cannulation cannot be achieved; furthermore, protrusion of the suture stent is a potential lifelong risk.
Methods: The specific design of the Stegmann Canal Expander allows a permanent expansion of the canal and distension of the trabecular meshwork.
Purpose: To evaluate clinically activated retinal astrocytes and Müller cells (ARAM) regarding retinal sensitivity and retinal nerve fiber layer (RNFL) thickness in primary open-angle glaucoma (POAG).
Methods: Central visual field (VF; i.e.
Dev Ophthalmol
September 2017
Ab externo Schlemm's canal (SC) surgery (e.g., viscocanalostomy and canaloplasty) is a valuable alternative to glaucoma filtration surgery.
View Article and Find Full Text PDFPurpose: To examine longer-term postsurgical safety and efficacy of a new expander for Schlemm's canal.
Methods: In a non-comparative, prospective study, 42 White patients with medically uncontrolled primary open-angle glaucoma (POAG) underwent primary canaloplasty with >2-year follow-up. The bleb-independent procedure comprised catheter-assisted canaloplasty and implantation of two Stegmann Canal Expanders to maintain trabecular distension and canal patency over 180°.
Purpose: To evaluate a new canal expander in circumferential viscocanalostomy (canaloplasty) for whites with primary open-angle glaucoma (POAG).
Design: Prospective, single-center, noncomparative study.
Participants: Twenty-two eyes of 22 consecutive patients with medically uncontrolled POAG underwent primary viscocanalostomy and implantation of the Stegmann Canal Expander into Schlemm canal with a follow-up time of at least 1 year.
Purpose. The object of this study was to investigate the role of the suture stent regarding its impact on reduction of intraocular pressure (IOP) in canaloplasty based on the distension of the inner wall of Schlemm's canal. Methods.
View Article and Find Full Text PDFThis study was performed to assess any changes in Schlemm's canal (SC) in human autopsy eyes possibly resulting from the injection of a viscoelastic substance and implantation of a new device (the Stegmann Canal Expander, SCE) into SC. After the surgical procedure, eyes were fixed, dissected into quartered segments and examined using light and scanning electron microscopy. Tissue sections displayed a marked dilation of SC and of the collector channels compared with untreated control sections.
View Article and Find Full Text PDFPurpose: To study the safety and long-term efficacy of classic viscocanalostomy in patients with open-angle glaucoma (OAG) in different populations.
Methods: A total of 726 eyes of 726 patients from Europe or South Africa with primary OAG (POAG) and pseudoexfoliative glaucoma (PXFG) were included in this retrospective multicentre study. Complete (qualified) success was defined as an intraocular pressure (IOP) equal to or lower than 21, 18 and 16 mmHg without (with or without) medications, respectively.
Background: Williams-Beuren syndrome is characterized by mild mental retardation, specific neurocognitive profile, hypercalcemia during infancy, distinctive facial features and cardiovascular diseases. We report on complete ophthalmologic, sonographic and genetic evaluation of a girl with a clinical phenotype of Williams-Beuren syndrome, associated with unilateral anterior segment dysgenesis and bilateral cleft of the soft and hard palate. These phenotypic features have not been linked to the haploinsufficiency of genes involved in the microdeletion.
View Article and Find Full Text PDFTraditional glaucoma surgery has been challenged by the advent of innovative techniques and new implants in the past few years. There is an increasing demand for safer glaucoma surgery offering patients a timely surgical solution in reducing intraocular pressure (IOP) and improving their quality of life. The new procedures and devices aim to lower IOP with a higher safety profile than fistulating surgery (trabeculectomy/drainage tubes) and are collectively termed "minimally invasive glaucoma surgery (MIGS).
View Article and Find Full Text PDFPurpose: Substantial evidence suggests that ocular perfusion is regulated by nitric oxide (NO), and polymorphisms in genes encoding for enzymes involved in NO formation and degradation (endothelial nitric oxide synthase [NOS3] and cytochrome b-235 alpha polypeptide gene [CYBA]) might contribute to vascular dysregulation observed in glaucoma. We therefore assessed the association of glaucoma with polymorphisms of NOS3 and CYBA previously associated with cardiovascular disease. We also compared the distribution of these polymorphisms in patients with high tension glaucoma (HTG) and normal tension glaucoma (NTG) and evaluated its association with vascular dysregulation in a subset of glaucoma patients.
View Article and Find Full Text PDFAb externo Schlemm's canal (SC) surgery (e.g. viscocanalostomy and canaloplasty) is a valuable alternative to glaucoma filtration surgery.
View Article and Find Full Text PDFPurpose: To assess risk factors for failure in canaloplasty.
Methods: Nonrandomized prospective study involving 51 eyes of 51 patients with medically uncontrolled primary open-angle glaucoma undergoing canaloplasty. Visual acuity, intraocular pressure (IOP) and slit-lamp examinations were performed before and after surgery at 1 and 7 days, and at 1 month and every 3 months thereafter.
Background/aims: To study the safety and effectiveness of 360° viscodilation and tensioning of Schlemm canal (canaloplasty) in black African patients with primary open-angle glaucoma (POAG).
Methods: Sixty randomly selected eyes of 60 consecutive patients with POAG were included in this prospective study. Canaloplasty comprised 360° catheterisation of Schlemm's canal by means of a flexible microcatheter with distension of the canal by a tensioning 10-0 polypropylene suture.
Purpose: To assess the safety and efficacy of canaloplasty (360-degree viscodilation and tensioning of the Schlemm canal) in Whites with open-angle glaucoma (OAG).
Methods: In a prospective study, 32 consecutive patients with medically uncontrolled OAG underwent primary canaloplasty with a follow-up time of more than 1 year. Laser goniopuncture was performed if postoperative intraocular pressure (IOP) was above 16 mmHg.
Invest Ophthalmol Vis Sci
March 2010
Purpose: To assess the aqueous outflow pathway in primary open-angle glaucoma (POAG) through provocative gonioscopy and channelography with a flexible microcatheter and fluorescein tracer during canaloplasty.
Methods: One eye each was randomly selected from 28 consecutive black African POAG patients undergoing canaloplasty. Provocative gonioscopy was performed at the beginning of surgery, and blood reflux from collector channels into Schlemm's canal (SC) was semiquantitatively evaluated.