Canaloplasty: First day microhyphaema

In a prospective, non-randomized study, my colleagues and I evaluated predictive factors for success in canaloplasty.¹⁰ The study group included 47 primary open angle glaucoma (POAG) patients with a mean IOP before surgery of 26.8 mmHg ± 5.2 (SD). The mean followup time was 20.6 months ± 8.3 (SD). The mean IOP was 8.4 mmHg ± 4.2 (SD) 1 day after surgery and 12.7 mmHg ± 1.7 (SD) at 24 months.

In a post-hoc analysis, there was no difference between patients with microhyphaema, compared to those without microhyphaema in regard to age, preoperative IOP, glaucomatous damage, number of medications and even in regard to day 1 IOP. However, the lower the target IOP after surgery was defined, the greater the differences in the complete success rates were between the two groups. For instance, the complete success rate in the eyes with microhyphaema was 87% compared to 21% in non-microhyphaema eyes for a target IOP under 16 mmHg, whereas it was 97% versus 71% respectively, for a target IOP less than 21 mmHg. Of note, eyes without microhyphaema required more frequent and earlier laser goniopuncture than eyes with microhyphaema (p < 0.001).