AIM: To evaluate the advantage of canaloplasty compared to trabeculectomy for patients with open angle glaucoma.· METHODS: Potentially relevant studies were systematically searched using various databases from in...AIM: To evaluate the advantage of canaloplasty compared to trabeculectomy for patients with open angle glaucoma.· METHODS: Potentially relevant studies were systematically searched using various databases from inception until December 2015. The outcome analyses performed automatically using Revman 5.3 included intraocular pressure reduction(IOPR), postoperative success rate, anti-glaucoma medications reduction and the incidence of adverse events.· RESULTS: We included four qualified studies incorporating a total of 215 eyes for quantitative synthesis. The weighted mean difference(WMD) of IOPR between canaloplasty and trabeculectomy from baseline to 12 mo was-2.33(95%CI:-4.00,-0.66). There was not significant improvement in the complete or qualified success rate(OR: 0.58, 95%CI: 0.26, 1.31; OR: 0.50, 95%CI: 0.10, 2.44, respectively). Similarly, no statistically significance was observed in anti-glaucoma mediations reduction(WMD:-0.54, 95% CI:-1.18, 0.09). Sensitivity analysis of the primary outcome estimate confirmed the stability of the Meta-analysis result.· CONCLUSION: Trabeculectomy seems to be more effective in lowering IOP up to 12 mo when comparing with canaloplasty. Canaloplasty does not seem to be inferior to trabeculectomy considering the postoperative success rate or the number of postoperative anti-glaucoma medications. Meanwhile, it has an advantage of less bleb related complications.展开更多
As a non-penetrating glaucoma surgery(NPGS), canaloplasty aims to reconstruct the physiological outflow of aqueous humor by dilating the Schlemm’s canal. Ab interno canaloplasty(ABiC), which can reconstruct the natur...As a non-penetrating glaucoma surgery(NPGS), canaloplasty aims to reconstruct the physiological outflow of aqueous humor by dilating the Schlemm’s canal. Ab interno canaloplasty(ABiC), which can reconstruct the natural outflow pathways of aqueous humor in mild-tomoderate primary open angle glaucoma(POAG) patients, is a new minimally invasive glaucoma surgery(MIGS) procedure improving from traditional canaloplasty. Canaloplasty can reduce intraocular pressure(IOP) with high efficiency and security. There are no complications such as scar formation and encapsulation for this no-bleb canaloplasty.展开更多
AIM: To report the outcomes of penetrating canaloplasty for corticosteroid-induced glaucoma in a case series.METHODS: Penetrating canaloplasty is a blebindependent filtering surger y unifying canaloplasty and trabecul...AIM: To report the outcomes of penetrating canaloplasty for corticosteroid-induced glaucoma in a case series.METHODS: Penetrating canaloplasty is a blebindependent filtering surger y unifying canaloplasty and trabeculectomy. In this study, the surger y was performed to restore the natural outflow through surgically expanded Schlemm’s canal and generated trabeculum ostium. A total of 10 eyes of 8 patients were treated with penetrating canaloplasty for corticosteroid-induced glaucoma. Intraocular pressure(IOP) and the number of glaucoma medications at postoperative 3, 6, 12, 18, 24,36, and 48mo were documented as primary endpoint.Complications after the surgery were recorded as secondary endpoint.RESULTS: Penetrating canaloplasty was accomplished successfully for all 10 eyes, with a mean follow-up of 20.4±13.0mo(range 6-48mo). The mean preoperative IOP and number of anti-glaucoma medications were 45.1±6.5 mm Hg and 3.3±0.5 respectively. The mean post-operative IOP at 3, 6, 12, 18, 24, 36, and 48mo were 15.8±6.0, 14.7±3.3,15.3±2.0, 15.6±2.6, 17.5±1.8, 16.5±4.9, and 14.0 mm Hg.The number of anti-glaucoma medications at these time points were all 0. This surgery failed to control the IOP in 1 eye at 1mo after surgery. Hyphaema occurred in 3 eyes on the first day after surgery. Postoperative transient IOP increasing was encountered with in two eyes from 1wk to 1mo after surgery. Choroidal detachment developed in one eye but responded well to conservative treatment.CONCLUSION: Penetrating canaloplasty is effective for corticosteroid-induced glaucoma without serious complications, making it a viable or preferred alternative option.展开更多
AIM: To present a new, simple, inexpensive Schlemm canal microcatheter for circumferential canaloplasty in a rabbit model. METHODS: A rabbit glaucoma animal model was established by intravitreal injection of triamcino...AIM: To present a new, simple, inexpensive Schlemm canal microcatheter for circumferential canaloplasty in a rabbit model. METHODS: A rabbit glaucoma animal model was established by intravitreal injection of triamcinolone acetonide. Circumferential canaloplasty with a new Schlemm canal microcatheter(patent license number: 201220029850.0) was performed. The Schlemm canal microcatheter was composed of microcatheter wall and lumen. The wall was made of high refractive index plastic optical fiber that could be attached to an illuminant so that the whole lighted microcatheter was visible during circumferential canaloplasty. The lumen could be attached to an injector for injection of viscoelastic during catheterization. Rabbits were divided randomly into the control, model and treatment groups. Intraocular pressure(IOP) was measured with a Tono-pen tonometer pre-operation and 3, 7, 14, 21 and 28 d post-operation. Ultrasound biomicroscopy was performed to visualize the Schlemm canal microcatheter in the Schlemm canal and the sclera pool.RESULTS: The Schlemm canal microcatheter could be used to perform circumferential canaloplasty in the rabbit glaucoma animal model. IOP was lower in the treatment group than that in the model group 3, 7, 14 and 28 d after operation. There were no significant differences in IOP between the control group and treatment group. The differences among the three groups were statistically significant(3 d: F=41.985, P<0.001; 7 d: F=65.696, P<0.001; 14 d: F=114.599, P<0.001; 28 d: F=55.006, P<0.001).CONCLUSION: Circumferential canaloplasty is safe and effective in control of experimental glaucoma model in rabbits.展开更多
Background:The aim of this study is to review the outcomes of canaloplasty versus canaloplasty combined with phacoemulsification in a retrospective cohort study and to evaluate the efficacy of these methods in terms o...Background:The aim of this study is to review the outcomes of canaloplasty versus canaloplasty combined with phacoemulsification in a retrospective cohort study and to evaluate the efficacy of these methods in terms of intraocular pressure(IOP)lowering effect,postoperative complications and additional glaucoma surgery or reintroduction of medical therapy over a 12-month follow-up.Methods:In a retrospective cohort study,602 eyes with primary open angle glaucoma(POAG)were treated with canaloplasty or canaloplasty combined with phacoemulsification.The results were evaluated separately in two main groups;group A canaloplasty(262 eyes)and group B canaloplasty combined with phaco(322 eyes).Each group was then subdivided into three additional groups according to the severity of glaucoma.The criteria for successful treatment were evaluated between three IOP ranges;IOP≤16 mmHg,18 mmHg and 21 mmHg.Complete success was considered the percentage of eyes reaching target IOP with no medication and partial success with medication.Groups A and B subgroups were compared using the Kaplan Meier test.Mean IOP,reduction of antiglaucoma agents and additional IOP lowering methods were also evaluated.The follow-up time was 12 months.Statistical significance was set at p<0.05.Results:An incomplete intraoperative cannulation of Schlemm’s canal resulting in conversion to other glaucoma surgery occurred in 18 eyes(2.99%).In both of the main groups,postoperative hyphema,descemet membrane detachment and transient IOP rise were the most common postoperative complications.The mean IOP in group A and subgroups at 12 months was 13.26±4.5 mmHg,15.19±3.97 mmHg and 18.09±3.75 mmHg.Respectively in group B mean IOP was 14.51±4.69 mmHg,14.40±4.11 mmHg and 14.25±2.76 mmHg.Complete success was achieved in group A in 69.19,74.51 and 74.31%of eyes.In group B complete success was achieved in 81.60,77.33 and 83.33%of eyes respectively.Kaplan Meier between groups A and B was statistically significant for IOP≤16 mmHg and IOP≤21 mmHg(p=0.0041 and p=0.0312),but not for IOP≤18 mmHg(p=0.6935).Partial success for IOP≤16 mmHg was 95.23 and 92.26%,for IOP≤18 mmHg was 91.66 and 90.47%and for IOP≤21 mmHg,90.00 and 93.10%,in groups A and B respectively.Twenty-three eyes received additional surgery(3.93%),10 trabeculectomies and 2 cyclophotocoagulation in group A,and 9 trabeculectomies and 2 cyclophotocoagulation in group B.Conclusion:Canaloplasty and canaloplasty combined with phacoemulsification significantly lower the IOP and have a lower postoperative complication rate.Additional glaucoma surgery or medication following both procedures is necessary if target IOP is unsatisfactory.In this study,canaloplasty combined with phacoemulsification demonstrated superior success rate compared to canaloplasty alone.展开更多
Acquired atresia of the external auditory canal(EAC)is a rare cause of conductive hearing loss.It has been traditionally classified into 4 categories:traumatic,post-operative,neoplastic and inflammatory.Post-inflammat...Acquired atresia of the external auditory canal(EAC)is a rare cause of conductive hearing loss.It has been traditionally classified into 4 categories:traumatic,post-operative,neoplastic and inflammatory.Post-inflammatory acquired auditory canal atresia is thought to be the result of chronic and repetitive infectious bouts affecting the auditory canal.Nevertheless,the underlying pathophysiology of this disorder is yet to be fully elucidated.Current data fail to clearly state the impact that certain underlying systemic disorders may have on the EAC.The possible association to metabolic disturbances such as iron deficiency is also emphasized.In the light of these findings,this analysis can be used to improve the classification of this entity thereby standardizing the assessment of therapeutic approaches.展开更多
文摘AIM: To evaluate the advantage of canaloplasty compared to trabeculectomy for patients with open angle glaucoma.· METHODS: Potentially relevant studies were systematically searched using various databases from inception until December 2015. The outcome analyses performed automatically using Revman 5.3 included intraocular pressure reduction(IOPR), postoperative success rate, anti-glaucoma medications reduction and the incidence of adverse events.· RESULTS: We included four qualified studies incorporating a total of 215 eyes for quantitative synthesis. The weighted mean difference(WMD) of IOPR between canaloplasty and trabeculectomy from baseline to 12 mo was-2.33(95%CI:-4.00,-0.66). There was not significant improvement in the complete or qualified success rate(OR: 0.58, 95%CI: 0.26, 1.31; OR: 0.50, 95%CI: 0.10, 2.44, respectively). Similarly, no statistically significance was observed in anti-glaucoma mediations reduction(WMD:-0.54, 95% CI:-1.18, 0.09). Sensitivity analysis of the primary outcome estimate confirmed the stability of the Meta-analysis result.· CONCLUSION: Trabeculectomy seems to be more effective in lowering IOP up to 12 mo when comparing with canaloplasty. Canaloplasty does not seem to be inferior to trabeculectomy considering the postoperative success rate or the number of postoperative anti-glaucoma medications. Meanwhile, it has an advantage of less bleb related complications.
文摘As a non-penetrating glaucoma surgery(NPGS), canaloplasty aims to reconstruct the physiological outflow of aqueous humor by dilating the Schlemm’s canal. Ab interno canaloplasty(ABiC), which can reconstruct the natural outflow pathways of aqueous humor in mild-tomoderate primary open angle glaucoma(POAG) patients, is a new minimally invasive glaucoma surgery(MIGS) procedure improving from traditional canaloplasty. Canaloplasty can reduce intraocular pressure(IOP) with high efficiency and security. There are no complications such as scar formation and encapsulation for this no-bleb canaloplasty.
基金Supported by National Key Research and Development Project of China (No.2020YFC2008200)Program for Zhejiang Leading Talent of S&T Innovation (No.2021R52012)+1 种基金Key Research and Development Projects of Zhejiang Province (No.2022C03112)Zhejiang Provincial Program for the Cultivation of Leading Talents in Colleges and Universities (No.2020099)。
文摘AIM: To report the outcomes of penetrating canaloplasty for corticosteroid-induced glaucoma in a case series.METHODS: Penetrating canaloplasty is a blebindependent filtering surger y unifying canaloplasty and trabeculectomy. In this study, the surger y was performed to restore the natural outflow through surgically expanded Schlemm’s canal and generated trabeculum ostium. A total of 10 eyes of 8 patients were treated with penetrating canaloplasty for corticosteroid-induced glaucoma. Intraocular pressure(IOP) and the number of glaucoma medications at postoperative 3, 6, 12, 18, 24,36, and 48mo were documented as primary endpoint.Complications after the surgery were recorded as secondary endpoint.RESULTS: Penetrating canaloplasty was accomplished successfully for all 10 eyes, with a mean follow-up of 20.4±13.0mo(range 6-48mo). The mean preoperative IOP and number of anti-glaucoma medications were 45.1±6.5 mm Hg and 3.3±0.5 respectively. The mean post-operative IOP at 3, 6, 12, 18, 24, 36, and 48mo were 15.8±6.0, 14.7±3.3,15.3±2.0, 15.6±2.6, 17.5±1.8, 16.5±4.9, and 14.0 mm Hg.The number of anti-glaucoma medications at these time points were all 0. This surgery failed to control the IOP in 1 eye at 1mo after surgery. Hyphaema occurred in 3 eyes on the first day after surgery. Postoperative transient IOP increasing was encountered with in two eyes from 1wk to 1mo after surgery. Choroidal detachment developed in one eye but responded well to conservative treatment.CONCLUSION: Penetrating canaloplasty is effective for corticosteroid-induced glaucoma without serious complications, making it a viable or preferred alternative option.
基金Supported by Fujian Provincial Science and Technology Department (No.2014Y4003)
文摘AIM: To present a new, simple, inexpensive Schlemm canal microcatheter for circumferential canaloplasty in a rabbit model. METHODS: A rabbit glaucoma animal model was established by intravitreal injection of triamcinolone acetonide. Circumferential canaloplasty with a new Schlemm canal microcatheter(patent license number: 201220029850.0) was performed. The Schlemm canal microcatheter was composed of microcatheter wall and lumen. The wall was made of high refractive index plastic optical fiber that could be attached to an illuminant so that the whole lighted microcatheter was visible during circumferential canaloplasty. The lumen could be attached to an injector for injection of viscoelastic during catheterization. Rabbits were divided randomly into the control, model and treatment groups. Intraocular pressure(IOP) was measured with a Tono-pen tonometer pre-operation and 3, 7, 14, 21 and 28 d post-operation. Ultrasound biomicroscopy was performed to visualize the Schlemm canal microcatheter in the Schlemm canal and the sclera pool.RESULTS: The Schlemm canal microcatheter could be used to perform circumferential canaloplasty in the rabbit glaucoma animal model. IOP was lower in the treatment group than that in the model group 3, 7, 14 and 28 d after operation. There were no significant differences in IOP between the control group and treatment group. The differences among the three groups were statistically significant(3 d: F=41.985, P<0.001; 7 d: F=65.696, P<0.001; 14 d: F=114.599, P<0.001; 28 d: F=55.006, P<0.001).CONCLUSION: Circumferential canaloplasty is safe and effective in control of experimental glaucoma model in rabbits.
文摘Background:The aim of this study is to review the outcomes of canaloplasty versus canaloplasty combined with phacoemulsification in a retrospective cohort study and to evaluate the efficacy of these methods in terms of intraocular pressure(IOP)lowering effect,postoperative complications and additional glaucoma surgery or reintroduction of medical therapy over a 12-month follow-up.Methods:In a retrospective cohort study,602 eyes with primary open angle glaucoma(POAG)were treated with canaloplasty or canaloplasty combined with phacoemulsification.The results were evaluated separately in two main groups;group A canaloplasty(262 eyes)and group B canaloplasty combined with phaco(322 eyes).Each group was then subdivided into three additional groups according to the severity of glaucoma.The criteria for successful treatment were evaluated between three IOP ranges;IOP≤16 mmHg,18 mmHg and 21 mmHg.Complete success was considered the percentage of eyes reaching target IOP with no medication and partial success with medication.Groups A and B subgroups were compared using the Kaplan Meier test.Mean IOP,reduction of antiglaucoma agents and additional IOP lowering methods were also evaluated.The follow-up time was 12 months.Statistical significance was set at p<0.05.Results:An incomplete intraoperative cannulation of Schlemm’s canal resulting in conversion to other glaucoma surgery occurred in 18 eyes(2.99%).In both of the main groups,postoperative hyphema,descemet membrane detachment and transient IOP rise were the most common postoperative complications.The mean IOP in group A and subgroups at 12 months was 13.26±4.5 mmHg,15.19±3.97 mmHg and 18.09±3.75 mmHg.Respectively in group B mean IOP was 14.51±4.69 mmHg,14.40±4.11 mmHg and 14.25±2.76 mmHg.Complete success was achieved in group A in 69.19,74.51 and 74.31%of eyes.In group B complete success was achieved in 81.60,77.33 and 83.33%of eyes respectively.Kaplan Meier between groups A and B was statistically significant for IOP≤16 mmHg and IOP≤21 mmHg(p=0.0041 and p=0.0312),but not for IOP≤18 mmHg(p=0.6935).Partial success for IOP≤16 mmHg was 95.23 and 92.26%,for IOP≤18 mmHg was 91.66 and 90.47%and for IOP≤21 mmHg,90.00 and 93.10%,in groups A and B respectively.Twenty-three eyes received additional surgery(3.93%),10 trabeculectomies and 2 cyclophotocoagulation in group A,and 9 trabeculectomies and 2 cyclophotocoagulation in group B.Conclusion:Canaloplasty and canaloplasty combined with phacoemulsification significantly lower the IOP and have a lower postoperative complication rate.Additional glaucoma surgery or medication following both procedures is necessary if target IOP is unsatisfactory.In this study,canaloplasty combined with phacoemulsification demonstrated superior success rate compared to canaloplasty alone.
文摘Acquired atresia of the external auditory canal(EAC)is a rare cause of conductive hearing loss.It has been traditionally classified into 4 categories:traumatic,post-operative,neoplastic and inflammatory.Post-inflammatory acquired auditory canal atresia is thought to be the result of chronic and repetitive infectious bouts affecting the auditory canal.Nevertheless,the underlying pathophysiology of this disorder is yet to be fully elucidated.Current data fail to clearly state the impact that certain underlying systemic disorders may have on the EAC.The possible association to metabolic disturbances such as iron deficiency is also emphasized.In the light of these findings,this analysis can be used to improve the classification of this entity thereby standardizing the assessment of therapeutic approaches.
