Ab interno canaloplasty combined with trabecular bypass stenting in eyes with primary open-angle glaucoma

摘要

Purpose: Evaluate outcomes of trabecular meshwork (TM) bypass (iStentsup?/sup GTS100) with cataract extraction (CE) and TM-bypass?+?ab interno canaloplasty (CP) (VISCO360sup?/sup) with CE in patients with primary open-angle glaucoma (POAG). Setting: Private surgical center for a comprehensive ophthalmology practice Design: Retrospective analysis of 186 eyes from 130 consecutive patients with 6?months follow-up. Methods: Eligible eyes had POAG, indicated for CE, and had received CE?+?TM-bypass or CE?+?TM-bypass?+?CP. Exclusions: glaucomas not POAG, SLT within 6?months, or previous ALT. IOP, visual acuity, and medication use assessed at baseline, months 1, 3, and 6. Endpoints were mean reduction in IOP from baseline at 6?months, proportion with IOP reduction at 6?months of ≥20% and IOP 18?mmHg on same or fewer medications, mean medication reduction, and proportion medication independent. Results: Eighty-six eyes comprised the CE?+?TM-bypass?+?CP group; 100 eyes in the CE?+?TM-bypass group. At 6?months: mean IOP reduction was 2.9±3.6?mmHg for CE?+?TM-bypass?+?CP and 1.7±3.1?mmHg for CE?+?TM-bypass group ( P 0.05); the proportion with IOP reduction of ≥20% and an IOP 18?mmHg on the same or fewer medications was 46% for CE?+?TM-bypass?+?CP and 35% for CE?+?TM-bypass; for both CE?+?TM-bypass?+?CP and CE?+?TM-bypass, mean number of medications was decreased (0.9 and 0.7, P 0.0001) with 56% and 48% off all medication. The most common AE were inflammation (6%) for CE?+?TM-bypass?+?CP group and VA loss (8%) for CE?+?TM-bypass. Conclusion: At six months, a greater proportion of CE?+?TM-bypass?+?CP patients achieved IOP reduction of ≥20% and an IOP 18?mmHg on the same or fewer medications than for TM-bypass?+?CE.