The Literature BY BENJAMIN ABRAMOWITZ, MD, AND NISHA CHADHA, MD PHACOEMULSIFICATION AND INTRAOCULAR LENS IMPLANTATION BEFORE, DURING, OR AFTER CANALOPLASTY IN EYES WITH OPEN- ANGLE GLAUCOMA: 3-YEAR RESULTS

SUMMARY This study was an international, retrospective subset analysis of 133 adult patients with open-angle glaucoma who underwent canaloplasty with tensioning suture placement. All patients had a baseline IOP of 16 mm Hg or higher within the past 60 days, a historical maximum IOP of 21 mm Hg or greater, and documented visual field loss. In addition, they all met each surgeon’s individual criteria for failure to respond adequately to maximally tolerated medical or laser therapy. Eighty-two phakic eyes underwent canaloplasty alone; 51 eyes received canaloplasty during or after cataract surgery and were then monitored for 3 years. The patients were organized into three groups: 1. phakic eyes that underwent canaloplasty 2. pseudophakic eyes that underwent canaloplasty 3. eyes that underwent combined phacoemulsification cataract extraction and canaloplasty The average preoperative IOP values were 23.4 ±4.3, 23.9 ±5.2, and 23.5 ±5.2 mm Hg in groups 1, 2, and 3, respectively. Three years postoperatively, the mean IOP values were 15.5 ±3.5, 15.6 ±3.5, and 13.6 ±3.6 mm Hg in groups 1, 2, and 3, respectively. Patients in group 3 had statistically significantly lower medication use (P < .001) than the other two groups after 3 years of follow-up, with the majority of patients in group 3 stopping topical glaucoma medication altogether. In addition, the overall failure rate in group 3 was lower compared with groups 1 and 2. There was no significant difference in mean visual acuity results at any study interval between the groups.