Purposes

To report the efficacy of a bleb-independent penetrating canaloplasty in the management of glaucoma secondary to iridocorneal endothelial syndrome (GS-ICE).

Design

Prospective, non-comparative clinical study.

Methods

Penetrating canaloplasty was performed on 35 eyes from 35 patients with GS-ICE and medically uncontrolled intraocular pressure (IOP) between January 2018 and April 2020. Patients were followed up at 1 week, months 1, 3, 6, 12 postoperatively, and semi-annually thereafter. The IOP, anti-glaucoma medication, and surgery-related complications were recorded. Surgical success was defined as IOP ≥ 5 mmHg and ≤ 21 mmHg without (complete success) or with/without (qualified success) IOP-lowering medication.

Results

A total of 29 eyes (82.9%) had 360° catheterization and successfully received penetrating canaloplasty. Of these eyes, 24 (82.8%) achieved qualified success and 22 (75.9%) achieved qualified success at 12 months after surgery. The mean IOP decreased from 39.5 ± 11.8 mmHg on 2.9 ± 1.0 medications before surgery to 16.6 ± 5.3 mmHg (P < .001) on 0.2 ± 0.6 medications (P < .001) at 12 months postoperatively, respectively. Hyphema (37.9%), transient hypotony (34.5%), and transient postoperative IOP elevation (≥ 30 mmHg, 17.9%) were the most commonly observed early complications at the 1 week and 1 month visits. From 1 month and beyond, all treated eyes showed no obvious bleb at the operation quadrant.

Conclusions

Penetrating canaloplasty rescued the inner aqueous outflow in ICE eyes and demonstrated acceptable success in IOP control with few complications, providing a new option for the management of GS-ICE.

中文翻译：

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在继发于虹膜角膜内皮综合征的青光眼中实现内部房水引流：穿透性鼻管成形术的一年结果

目的

报告不依赖于滤泡的穿透性泪管成形术在治疗继发于虹膜角膜内皮综合征 (GS-ICE) 的青光眼中的疗效。

设计

前瞻性、非比较性临床研究。

方法

2018 年 1 月至 2020 年 4 月期间，对 35 名 GS-ICE 且眼内压（IOP）无法控制的患者的 35 只眼进行了穿透性泪管成形术。患者在术后 1 周、第 1、3、6、12 个月和半月进行了随访。此后每年一次。记录眼压、抗青光眼药物和手术相关并发症。手术成功定义为 IOP ≥ 5 mmHg 且 ≤ 21 mmHg，无需（完全成功）或有/无（合格成功）IOP 降低药物。

结果

共有29只眼（82.9%）进行了360°导尿并成功接受了穿透性鼻管成形术。在这些眼睛中，24 只 (82.8%) 取得了合格的成功，22 只 (75.9%) 在手术后 12 个月取得了合格的成功。术后 12 个月，平均 IOP 从术前服用 2.9 ± 1.0 种药物的 39.5 ± 11.8 mmHg 下降到服用 0.2 ± 0.6 种 药物 ( P < .001) 的 16.6 ± 5.3 mmHg ( P < .001)。前房积血 (37.9%)、一过性低眼压 (34.5%) 和一过性术后 IOP 升高（≥ 30 mmHg，17.9%）是在 1 周和 1 个月就诊时最常见的早期并发症。1个月及以后，所有治疗眼在手术象限内均未见明显水疱。

结论

穿透性泪管成形术挽救了 ICE 眼的内部房水流出，并在 IOP 控制方面取得了可接受的成功，并发症很少，为 GS-ICE 的管理提供了新的选择。