scholarly journals Canaloplasty: Current Value in the Management of Glaucoma

2016 ◽  
Vol 2016 ◽  
pp. 1-6 ◽  
Author(s):  
Carlo Cagini ◽  
Claudia Peruzzi ◽  
Tito Fiore ◽  
Leopoldo Spadea ◽  
Myrta Lippera ◽  
...  
Keyword(s):  
Surgical Technique ◽  
Open Angle Glaucoma ◽  
Open Angle ◽  
Moderate Disease ◽  
Prolene Suture ◽  
Current Value ◽  
Lens Opacities ◽  
Clinically Significant ◽  
Aqueous Outflow ◽  
Fistulating Surgery

Canaloplasty is a nonpenetrating blebless surgical technique for open-angle glaucoma, in which a flexible microcatheter is inserted within Schlemm’s canal for the entire 360 degrees. When the microcatheter exits the opposite end, a 10-0 prolene suture is tied and it is then withdrawn, by pulling microcatheter back through the canal in the opposite direction. Ligation of prolene suture provides tension on the canal and facilitates aqueous outflow. The main advantage of canaloplasty is that this technique avoids the major complications of fistulating surgery related to blebs and hypotony. Currently, canaloplasty is performed in glaucoma patients with early to moderate disease and combination with cataract surgery is a suitable option in patients with clinically significant lens opacities.

scholarly journals Canaloplasty in Open-Angle Glaucoma Surgery: A Four-Year Follow-Up

2014 ◽  
Vol 2014 ◽  
pp. 1-7 ◽  
Author(s):  
Paolo Brusini
Keyword(s):  
Open Angle Glaucoma ◽  
Glaucoma Surgery ◽  
Open Angle ◽  
Schlemm’S Canal ◽  
Schlemm's Canal ◽  
Prolene Suture ◽  
Surgical Learning ◽  
Mid Term Results ◽  
Aqueous Outflow

Canaloplasty is a new nonperforating surgical technique for open-angle glaucoma, in which a microcatheter is inserted within Schlemm’s canal for the entire 360 degrees. A 10-0 prolene suture, which is tied to the distal tip of the microcatheter, is then positioned and left tensioned in Schlemm’s canal, thus facilitating aqueous outflow through natural pathways. A small amount of viscoelastic agent is delivered in Schlemm’s canal while the catheter is withdrawn. The mid-term results are very promising. Based on our cohort of 214 patients, the percentages of eyes that obtained postoperative IOP≤21 mmHg,≤18 mmHg, and≤16 mmHg with or without medical therapy after 2 and 3 years were 88.7%, 73.7%, and 46.2% (2 years); 86.2%, 58.6%, and 37.9% (3 years), respectively. The most frequent complications observed included hyphema; descemet membrane detachment; IOP spikes; and hypotony. The advantages of canaloplasty over trabeculectomy include (1) no subconjunctival bleb; (2) no need for antimetabolites; (3) fewer postoperative complications; and (4) a simplified follow-up. The disadvantages include the following: (1) a long and rather steep surgical learning curve; (2) the need of specific instruments; (3) average postoperative IOP levels tend not to be very low; and (4) impossibility to perform the entire procedure in some cases.

scholarly journals 25-Hydroxyvitamin D and matrix metalloproteinases-2, -9 level in patients with primary open angle glaucoma and pseudoexfoliative glaucoma/syndrome

2017 ◽  
Vol 10 (1) ◽  
pp. 10-16
Author(s):  
Inessa S Beletskaya ◽  
Tatiana L Karonova ◽  
Sergey Yu Astakhov
Keyword(s):  
Vitamin D ◽  
Vitamin D Deficiency ◽  
Primary Open Angle Glaucoma ◽  
Open Angle Glaucoma ◽  
Study Groups ◽  
Control Group ◽  
Open Angle ◽  
Hydroxyvitamin D ◽  
Study Results ◽  
Clinically Significant

Aim. To determine serum 25(OH)D and plasma MMP-2 and MMP-9 levels in patients with primary open-angle glaucoma (POAG), pseudoexfoliation glaucoma (PEG), and pseudoexfoliation syndrome (PES) - to assess potential associations between vitamin D status and these diseases. Methods. We included 238 patients (105 males and 133 females) aged from 55 to 75 years. One hundred twenty two patients had PEG, 46 patients had POAG, 32 had PES. 38 subjects were healthy, and were considered as the control group. Cases with clinically significant systemic diseases and concomiatant eye diseases were excluded, if there was a confirmed pathogenic impact of vitamin D and MMP. The serum 25(OH)D level was investigated by immunochemiluminescence method, plasma MMP-2 and MMP-9 levels - by ELISA. Results. Serum 25(OH)D level was between 4.6 and 82.25 nM/l (mean 41.7 nM/l), so most participants showed vitamin D deficiency. It was shown that mean serum 25(OH)D level in patients with PEG, POAG and PES was similar (39.3 ± 1.2, 38.8 ± 2.1 and 40.51 ± 2.4 nM/l, p > 0.05), but it was lower than that in the control group (52.7 ± 2.1 nM/l, p < 0.01). Plasma MMP-2 concentration was the same in all study groups. Plasma MMP-9 level was higher in POAG and PES patients (48.23 ± 3.26 and 54.01 ± 3.57 ng/ml) than in the control group (32.60 ± 2.34 ng/ml, p < 0.001) and PEG patients (40.86 ± 3.60 ng/ml, p < 0.05). We found positive correlations between MMP-2 and MMP-9 levels in patients with PEG (r = 0.48, p = 0.001) and patients with POAG (r = 0.43, p = 0.003). The correlation analysis showed also a negative relation between 25(OH)D and MMP-9 (r = -0.32, p = 0.02), MMP-2 (r = -0.33, p = 0.02) in patients with POAG. Summary. Study results confirmed a potential role of vitamin D in apoptosis regulation and tissue remodeling in patients with POAG and PES. Hence, vitamin D deficiency can be considered as a risk factor for glaucoma development.

Complications Specifically Related to Trabeculotomy in Adults

2013 ◽  
Author(s):  
Adam C. Reynolds ◽  
Ronald L. Fellman
Keyword(s):  
Anterior Chamber ◽  
Trabecular Meshwork ◽  
New Technologies ◽  
Open Angle Glaucoma ◽  
Venous Pressure ◽  
Congenital Glaucoma ◽  
Surgical Approaches ◽  
Retrograde Flow ◽  
Open Angle ◽  
Clinically Significant

Disruptive or ablative surgeries involving the trabecular meshwork and Schlemm’s canal, which have traditionally been applied to the developmental and congenital glaucomas, are currently receiving renewed interest in adult open-angle glaucoma because of the development of new technologies. The Trabectome® (NeoMedix Corporation, Tustin, California) procedure, canaloplasty with or without stent, direct trabecular bypass, excimer laser trabeculotomy (ELT), and other techniques in development are all based in their surgical approaches on classic trabeculotomy. Some of the proposed mechanisms of action, as well as the potential complications that occur in classic angle surgeries, are also likely quite similar. It is prudent to note that in some specific limited populations, adult trabeculotomy ab externo has long been employed. For example, in Japan trabeculotomy has been used in adult open-angle glaucoma, and even in North America there have been studies of trabeculotomy combined with cataract surgery. It is well accepted that any and all of the complications related to these procedures in congenital glaucoma can occur when applied to the adult eye, and mitigation and avoidance of them are likely very similar. Some specific complications may be more likely in adult eyes. By far the most common complication related to trabeculotomy, whether in adults or children, is hyphema. In fact it is expected, and some bleeding should be considered a sign that the procedure was done correctly rather than a complication. However, in several large clinical series from Japan, rates of clinically significant postoperative hyphema in adult trabeculotomy often approach 20%. It is thought that hyphema occurs due to disruption of the trabecular meshwork, as a barrier between retrograde flow of blood from the collector channel system into the anterior chamber is removed at least temporarily. Once the trabecular meshwork is disrupted, if the intraocular pressure (IOP) is lower than the episcleral venous pressure (EVP), retrograde flow of blood into the anterior chamber may result. One commonly employed technique to avoid significant hyphema in trabeculotomy is to temporarily “tamponade” the anterior chamber with viscoelastic.

scholarly journals The Effects of Prostaglandin Analogs on Intraocular Pressure in Human Eye for Open Angle Glaucoma

2020 ◽  
Vol 10 (2) ◽  
pp. 176-180
Author(s):  
Shabab Akbar ◽  
Sapna Ratan Shah
Keyword(s):  
Fluid Flow ◽  
Intraocular Pressure ◽  
Aqueous Humor ◽  
Trabecular Meshwork ◽  
Ciliary Body ◽  
Open Angle Glaucoma ◽  
Posterior Chamber ◽  
Open Angle ◽  
Permeable Channel ◽  
Aqueous Outflow

The effects of Prostaglandin Analogs on intraocular pressure and increased aqueous outflow via trabecular meshwork into the schlemm’s canal has been studied in this present research paper. Aqueous humor is an outflow, which flows at the back of the iris in the posterior chamber all the way through the pupil aperture, out into the anterior chamber, and drain from the eye via drainage slope. The eye keeps on making aqueous humor in the ciliary body and it passes through the trabecular meshwork into the scheme of the canal, the key drainage from the eye and it finally goes to the “collector channels” and due to the less amount of aqueous humor fluid flow from the drainage angle, the pressure in the eye starts to increase. For this study, the canal of Schlemm is assumed as a permeable channel. And it is connected by trabecular meshwork. The inner layer of the canal's wall has been assumed as permeable. And the aqueous humor drains into the canal through this porous tissue wall. The objective of this paper is to discuss the effect of prostaglandin analogs on intraocular pressure as the Prostaglandin Analogs work by increasing the outflow of aqueous from the eye.

Anticholinestisrase enedrops in chronic simple glaucoma

1966 ◽  
Vol 4 (4) ◽  
pp. 14-15
Keyword(s):  
Visual Field ◽  
Trabecular Meshwork ◽  
Open Angle Glaucoma ◽  
Direct Action ◽  
Ciliary Muscle ◽  
Open Angle ◽  
Intra Ocular Pressure ◽  
Medical Control ◽  
Ocular Pressure ◽  
Aqueous Outflow

The medical control of chronic simple (open-angle) glaucoma is becoming more popular, and newer and more potent drugs have been produced to reduce the intra-ocular pressure. The anticholinesterases are one such group of drugs; they potentiate acetylcholine and increase aqueous outflow from the eye, perhaps by stimulating the ciliary muscle which pulls on the scleral spur, or by direct action on parasympathetic end-organs in the trabecular meshwork. The effect lasts many hours or even several days, thus achieving the uninterrupted control of intra-ocular pressure essential to prevent further loss of visual field.

scholarly journals Combining Ab Interno Kahook Trabeculectomy with Gonioscopy-Assisted Transluminal Trabeculotomy Reduces Intraocular Pressure

2019 ◽  
Vol 184 (11-12) ◽  
pp. 934-936
Author(s):  
Jared R Widder ◽  
Joseph W Schmitz
Keyword(s):  
Intraocular Pressure ◽  
Surgical Technique ◽  
Open Angle Glaucoma ◽  
Glaucoma Surgery ◽  
Active Duty ◽  
Pharmacologic Therapy ◽  
Open Angle ◽  
Elevated Intraocular Pressure ◽  
Kahook Dual Blade ◽  
Ab Interno

Abstract Minimally invasive glaucoma surgery (MIGS) provides a safe option for individuals with mild to moderate open-angle glaucoma to reduce their need for pharmacologic therapy or more extensive ab externo surgeries. In this report, we describe a surgical technique using both the Kahook Dual Blade and Gonioscopy-assisted transluminal trabeculotomy (GATT), to treat a 23-year-old active duty female with idiopathic uveitis and subsequent corticosteroid-induced glaucoma who presented with consistently elevated intraocular pressure (IOP) measurements despite maximal pharmacologic interventions. This combination was effective in consistently lowering intraocular pressure for at least 12 months in a young, phakic, active duty patient with uveitis and steroid-responsive open-angle glaucoma.

scholarly journals A Histologic Categorization of Aqueous Outflow Routes in Familial Open-Angle Glaucoma and Associations With Mutations in the MYOC Gene in Japanese Patients

2017 ◽  
Vol 58 (5) ◽  
pp. 2818 ◽  
Author(s):  
Teruhiko Hamanaka ◽  
Masae Kimura ◽  
Tetsuro Sakurai ◽  
Nobuo Ishida ◽  
Jun Yasuda ◽  
...  
Keyword(s):  
Open Angle Glaucoma ◽  
Japanese Patients ◽  
Open Angle ◽  
Aqueous Outflow
Sign in / Sign up

Export Citation Format

Share Document