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Safety and Efficacy of Three Variants of Canaloplasty With Phacoemulsification to Treat Glaucoma and Cataract

Not Applicable
Conditions
Primary Open Angle Glaucoma, Cataract
Interventions
Procedure: canaloplasty and phacoemulsification
Registration Number
NCT02908633
Lead Sponsor
Military Institute od Medicine National Research Institute
Brief Summary

It is a comparative study of Safety and Efficacy of Three Variants of Canaloplasty: ab-externo, ab-interno and minicanaloplasty. Combined With Phacoemulsification to Treat Glaucoma and Cataract. It is a Randomised, Prospective Study.

Detailed Description

Not available

Recruitment & Eligibility

Status
UNKNOWN
Sex
All
Target Recruitment
90
Inclusion Criteria
  • co-existing glaucoma and cataract
  • glaucoma types: primary open angle glaucoma,
  • eye with characteristic glaucoma changes (biomicroscopic,visual field)
  • IOP over 21 mmHg after washout
  • patients not tolerating antiglaucoma medications,
  • patients with poor compliance
  • progression in visual field
Exclusion Criteria
  • previous surgical glaucoma procedure
  • previous cataract surgery
  • BCVA under 0,004
  • closed angle glaucoma secondary glaucoma (pseudoexfoliative, pigmentary)
  • poorly controlled diabetes mellitus
  • advanced AMD
  • active inflammatory disease
  • pregnancy
  • mental disease or emotional instability general steroid therapy

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
minicanaloplasty and phacoemulsificationcanaloplasty and phacoemulsificationThe dissected conjunctival flap is of minimal size. The scleral flaps are sized: superficial flap 3x1mm, and deep flap: 1x1 mm- with no removal of the deep flap. Afterwards phacoemulsification part is performed. The microcatheterization and viscodilatation are conducted as in the traditional procedure.The conjunctiva is closed with one suture or coagulation
canaloplasty ab externo and phacoemulsificationcanaloplasty and phacoemulsificationAs soon as the two scleral flaps: deep and superficial -similar to deep sclerectomy are dissected, the phacoemulsification with PCIOL insertion is performed. After excision of the deep flap the descemets window and ostia of Schlemm canal are created, the microcatheter is placed in the canal and guided for 360 degrees within the canal. Surgeon observes the location of beacon tip through sclera and injects the Healon GV. Then a suture is tied to the distal tip and the microcatheter is withdrawn. As it appears at the other ostium of canal the microcatheter it separated from the suture.Then suture loop is tightened to tension the trabecular meshwork. The superficial flap is sutured watertight to prevent bleb formation
canaloplasty ab interno and phacoemulsificationcanaloplasty and phacoemulsificationThis variant of canaloplasty spares conjunctival surface. First phacoemulsification and PCIOL placement is performed. The Schlemm's canal is reached through goniotomy through anterior chamber. Similarly microcatheter is inserted and viscodilatator applicated. The key difference, is that no tensioning suture is left after the catheter is withdrawn. phacoemulsification is performed.
Primary Outcome Measures
NameTimeMethod
mean IOPchange form baseline at 24 months
Number of antiglaucoma drugschange from baseline at 24 months
intraoperative complicationsat the day of surgery
Secondary Outcome Measures
NameTimeMethod
Best-Corrected Visual Acuitychange from baseline at 24 months
Visual Field changeschange from baseline at 24 months

MD,

Early and Late postsurgical complicationswithin 24 months
% IOP reductionchange at 24 months from baseline

Trial Locations

Locations (1)

Military Institute of Medicine

🇵🇱

Warsaw, Poland

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