Department of Ophthalmology, Riga Stradins University, Riga, Latvia.
Department of Ophthalmology, Manchester University Hospitals NHS Trust, Manchester Royal Eye Hospital, Manchester, UK.
Eur J Ophthalmol. 2022 Jan;32(1):712-716. doi: 10.1177/11206721211000275. Epub 2021 Mar 11.
We report on a 56-year-old male with primary open-angle glaucoma who underwent mitomycin C augmented canaloplasty enabling filtration in the right eye after cataract surgery combined with a Schlemm's canal microstent 3 years previously. He showed progressive glaucomatous optic neuropathy and was highly myopic (axial length 32.05 mm, spherical equivalent -18.75 dioptres in the right eye). Augmented canaloplasty was performed uneventfully and 360° catheterisation was achieved followed by the placement of a 10-0 polypropylene suture in Schlemm's canal. Intraocular pressure (IOP) in the first post-operative day was reduced from 19 to 6 mmHg. At 1-month follow-up IOP was 12 mmHg off glaucoma medications. The presence of a minimally invasive glaucoma surgery (MIGS) device did not hinder successful catheterisation of Schlemm's canal. Significant reduction of IOP was obtained in the early post-surgical period. No intra-operative complications were registered and only transient hyphema in early post-operative period was reported. This augmented canaloplasty could be an effective alternative to trabeculectomy even after Schlemm's canal microstent implantation.
我们报告了一例 56 岁男性原发性开角型青光眼患者，该患者曾在 3 年前接受过丝裂霉素 C 增强的小梁切开术，在白内障手术后联合 Schlemm 管微支架，右眼可滤过。他表现出进行性青光眼视神经病变和高度近视（右眼眼轴长 32.05mm，等效球镜-18.75 屈光度）。增强的小梁切开术顺利进行，并进行了 360°导管插入术，随后在 Schlemm 管中放置了 10-0 聚丙烯缝线。术后第一天眼压（IOP）从 19mmHg 降至 6mmHg。术后 1 个月随访时，IOP 脱离青光眼药物治疗为 12mmHg。微创青光眼手术（MIGS）装置的存在并未妨碍 Schlemm 管的成功导管插入术。在术后早期获得了显著降低的眼压。未记录到术中并发症，仅报告了早期术后短暂的前房积血。即使在 Schlemm 管微支架植入后，这种增强的小梁切开术也可能成为小梁切除术的有效替代方法。
