Abstract:

Objective To observe the preliminary application of the domestic illuminated microcatheter on penetrating canaloplasty. Design Prospective case series. Participants 30 cases (30 eyes) of glaucoma patients were treated with the penetrating canaloplasty from May 2018 to August 2018 in Eye Hospital of Wenzhou Medical University. Methods A window at the corneal-scleral bed after the canaloplasty using the domestic illuminated microcatheter was made, enabling aqueous to redirect into the opening of schlemm canal with intension sutures. No antimetabolite agents were used in the surgical procedure. Time points of follow-up were arranged at 1 day, 1 week, 1, 3 and 6 months after the surgery. Qualified success was defined as intraocular pressure (IOP)≤21 mmHg with medication. Complete success was defined as IOP≤21 mmHg without medication. Main Ooutcome Measures Rate of circumferential catheterization of the canal, IOP, number of medication, surgical success rate and complications. Results 23 eyes (76.7%) achieved the 360 degrees’ catheterization of the canal. The mean preoperative IOP was （34.3±13.9） mmHg. The mean IOP at 1 day, 1 week, 1, 3 and 6 months after the surgery was （15.0±9.7） mmHg, （17.3±8.8） mmHg, （15.6±3.7） mmHg, （13.9±6.1） mmHg and （13.4±3.3）mmHg, respectively (P<0.001). The mean number of preoperative medication was 3.4±1.2. The mean number of postoperative medication was 0.2±0.9, 0.5±0. 9, 0.2±0.5, 0.1±0.2 and 0.2±0.5, respectively (P<0.05). Surgical success rate at 6 month after surgery was 95.0%(19/20) (qualified success) and 85.0%（17/20）(complete success), respectively. With regard to complications, hyphema was observed in 4 eyes（18.2%）, meanwhile hypotony and grade I shallow anterior chamber was observed in one of the eyes（4.5%）. No filtering bleb was observed in 19 eyes (95.0%)  at 6-month after the surgery. Additionally，transient elevated IOP was observed in 9 eyes (40.9%). Conclusion The result of six-month follow-up shows the domestic illuminated microcatheter can achieve about 75% success rate of circumferential catheterization in the procedure of penetrating canaloplasty. Obvious IOP reduction and few filtering blebs were observed. Longer-term follow-up is required.

Key words: domestic illuminated microcatheter, penetrating canaloplasty, glaucoma/surgery