Objective: To compare the safety and efficacy between canaloplasty and aqueous drainage pathway reconstruction surgery in patients with open-angle glaucoma (OAG).
Methods: It is a retrospective case series study. Thirty-one eyes (25 patients) with OAG were divided into canaloplasty (n = 17; 54.8%) group or aqueous drainage pathway reconstruction (n = 14; 45.2%) group. The intraocular pressure (IOP), numbers of IOP-lowering medications and incidence of complications were recorded at 1 day, 1 week, 1, 3, 6 and 12 months after the operation. Independent-samples T test was used to compare the IOP, numbers of IOP-lowering medications before and 1, 3, 6, 12, 24 months after surgery between two groups. Kaplan-Meier Survival Analysis was used to analyze the success rate of these two surgical methods. Log rank test was used to compare the difference of cumulative success rate at 6, 12 months after surgery.
Results: The mean IOP values were (24.7 ± 8.7) , (14.5 ± 2.5), (14.9 ± 2.5) , (14.9 ± 2.5), (14.7 ± 2.1) and (15.4 ± 2.3) mmHg (1 mmHg = 0.133 kPa) in canaloplasty group at before surgery, 1, 3, 6, 12 and 24 months after surgery. The same values were (28.5 ± 10.6), (14.3 ± 3.6), (14.2 ± 3.2), (14.3 ± 3.6), (15.9 ± 3.2) and (14.6 ± 0.7) mmHg in aqueous drainage pathway reconstruction group. There was no difference in the extent of IOP reduction between these two groups (preoperative: t = -1.1014, P = 0.278; postoperative 1 month: t = 0.696, P = 0.492;3 month: t = 0.594, P = 0.557; 6 month: t = 0.536, P = 0.596; 12 month: t = -1.127, P = 0.273; 24 month: t = 0.455, P = 0.656). There were significant differences (P < 0.01) in post-surgery IOP lowering medication usage between these two groups, while pre-surgery medication usage were similar. The incidence of hyphema was significantly lower in aqueous drainage pathway reconstruction surgery group (2 eyes) than that in canaloplasty group (11 eyes).
Conclusions: Both canaloplasty and aqueous drainage pathway reconstruction could reduce IOP effectively for open-angle glaucoma. The incidence of complication was lower in the aqueous drainage pathway reconstruction group than canaloplasty group. However, long-term efficacy between these two groups is yet to be determined.