title: Efficacy, safety, and survival rates of IOP-lowering effect of phacoemulsification alone or combined with canaloplasty in glaucoma patients.
abstract: OBJECTIVE
  To evaluate efficacy and survival rates of intraocular pressure (IOP)-lowering effect obtained with phacoemulsification (phaco) alone or in combination with canaloplasty (PCP) in patients with open-angle glaucoma (OAG).
  
  
  METHODS
  Retrospective chart review of consecutive cases at the Department of Ophthalmology, Indiana University. Visual acuity (VA), IOP, number of medications (Meds), failures, and survival rates of IOP-lowering effect were analyzed. Inclusion criteria were: patients older than 18 years with OAG and cataract. Exclusion criteria were: no light perception vision, prior glaucoma surgery, chronic uveitis, angle-closure glaucoma, and advanced-stage or end-stage OAG. Failure criteria were: IOP>21 mm Hg or <20% reduction, IOP<6 mm Hg, further glaucoma surgeries, and loss of light perception vision.
  
  
  RESULTS
  Thirty-seven patients underwent phaco and 32 patients had PCP. Follow-up was 21.8±10.1 versus 18.8±9.6 months for phaco and PCP, respectively (P=0.21). Age (y) (74.7±9.8 vs. 76.1±8.3, P=0.54), sex (P=81), and laser status (P=0.75) were similar between the groups. Preoperatively, mean±SD logMAR VA (0.5±0.7 vs. 0.5±0.5, P=0.77), IOP (16.2±4.6 vs. 18.2±5.1, P=0.13), and Meds (1.4±1.1 vs. 1.3±0.7, P=0.75) were similar for phaco and PCP, respectively. At 24-month phaco (n=17) and PCP (n=11), respectively, mean±SD were: logMAR VA 0.2±0.2 versus 0.4±0.7, P=0.29; IOP 14.1±4.0 versus 12.9±3.8, P=0.43; and Meds 1.5±1.2 versus 0.3±0.5, P=0.005. Rates of successful IOP lowering without medications for phaco versus PCP at 12 months were 34% versus 75%, respectively (P=0.003).
  
  
  CONCLUSIONS
  A combination of canaloplasty with phaco results in a decreased number of glaucoma medications and increased survival rate of IOP-lowering effect compared with phaco alone.
authors: *Department of Ophthalmology, Glaucoma Service, Eugene and Marilyn Glick Eye Institute, Indiana University School of Medicine, Indianapolis, IN †Department of Ophthalmology, Washington University, St Louis, MO.
authors: Stella N
authors: SN
authors: Arthur
authors: Louis B
authors: LB
authors: Cantor
authors: Darrell
authors: D
authors: WuDunn
authors: Guruprasad R
authors: GR
authors: Pattar
authors: Yara
authors: Y
authors: Catoira-Boyle
authors: Linda S
authors: LS
authors: Morgan
authors: Joni S
authors: JS
authors: Hoop
mesh_terms: D000368:Aged; D000959:Antihypertensive Agents / Q000627:therapeutic use; D005260:Female; D018463:Filtering Surgery / Q000379:methods*; D005500:Follow-Up Studies; D005902:Glaucoma, Open-Angle / Q000401:mortality / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D007429:Intraocular Pressure / Q000502:physiology*; D008297:Male; D018918:Phacoemulsification / Q000379:methods*; D012189:Retrospective Studies; D015996:Survival Rate; D016896:Treatment Outcome; D014792:Visual Acuity / Q000502:physiology
chemical_list: D000959:Antihypertensive Agents