title: Canaloplasty: Three-year results of circumferential viscodilation and tensioning of Schlemm canal using a microcatheter to treat open-angle glaucoma.
abstract: OBJECTIVE
  To report 3-year results of the safety and efficacy of canaloplasty, a procedure involving circumferential viscodilation and tensioning of the inner wall of Schlemm canal to treat open-angle glaucoma.
  
  
  METHODS
  Multicenter surgical sites.
  
  
  METHODS
  Nonrandomized multicenter clinical trial.
  
  
  METHODS
  This study comprised adult open-angle glaucoma patients having canaloplasty or combined cataract-canaloplasty surgery. Qualifying preoperative intraocular pressures (IOPs) were at least 16 mm Hg with historical IOPs of at least 21 mm Hg. A flexible microcatheter was used to viscodilate the full circumference of the canal and to place a trabecular tensioning suture. Primary outcome measures included IOP, glaucoma medication use, and adverse events.
  
  
  RESULTS
  Three years postoperatively, all study eyes (n = 157) had a mean IOP of 15.2 mm Hg ± 3.5 (SD) and mean glaucoma medication use of 0.8 ± 0.9 compared with a baseline IOP of 23.8 ± 5.0 mm Hg on 1.8 ± 0.9 medications. Eyes with combined cataract-canaloplasty surgery had a mean IOP of 13.6 ± 3.6 mm Hg on 0.3 ± 0.5 medications compared with a baseline IOP of 23.5 ± 5.2 mm Hg on 1.5 ± 1.0 medications. Intraocular pressure and medication use results in all eyes were significantly decreased from baseline at every time point (P<.001). Late postoperative complications included cataract (12.7%), transient IOP elevation (6.4%), and partial suture extrusion through the trabecular meshwork (0.6%).
  
  
  CONCLUSIONS
  Canaloplasty led to a significant and sustained IOP reduction in adult patients with open-angle glaucoma and had an excellent short- and long-term postoperative safety profile.
  
  
  BACKGROUND
  No author has a financial or proprietary interest in any material or method mentioned. Additional disclosures are found in the footnotes.
authors.affiliation: Grutzmacher & Lewis, Sacramento, California 95815, USA. rlewiseyemd@yahoo.com
authors.forename: Richard A
authors.initials: RA
authors.lastname: Lewis
authors.forename: Kurt
authors.initials: K
authors.lastname: von Wolff
authors.forename: Manfred
authors.initials: M
authors.lastname: Tetz
authors.forename: Norbert
authors.initials: N
authors.lastname: Koerber
authors.forename: John R
authors.initials: JR
authors.lastname: Kearney
authors.forename: Bradford J
authors.initials: BJ
authors.lastname: Shingleton
authors.forename: Thomas W
authors.initials: TW
authors.lastname: Samuelson
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000959:Antihypertensive Agents / Q000008:administration & dosage; D002387:Cataract Extraction; D002408:Catheters, Indwelling; D005260:Female; D018463:Filtering Surgery / Q000379:methods*; D005902:Glaucoma, Open-Angle / Q000601:surgery*; D006801:Humans; D007429:Intraocular Pressure; D007431:Intraoperative Complications; D008297:Male; D033401:Microscopy, Acoustic; D008875:Middle Aged; D011183:Postoperative Complications; D011446:Prospective Studies; D016896:Treatment Outcome; D014792:Visual Acuity / Q000502:physiology
chemical_list: D000959:Antihypertensive Agents